34D2021419 CLIA NUMBER - HEALTHSTAT ON-SITE CLINIC - COCA COLA

Laboratory Demographics

  • CLIA Code: 34D2021419
  • Facility Name: HEALTHSTAT ON-SITE CLINIC - COCA COLA
  • Facility Address: 4901 CHESAPEAKE DR
    CHARLOTTE, NC
    ZIP 28216
  • Facility Phone: 704 557-4615
  • Facility Type: Other - CHRNC DISEASE MGT CLINIC
  • Facility Type: Waiver
  • Lab Director: DR. SANDRA SIMS
  • NPI Number: 1164033767
  • Taxonomy: 2083P0500X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D2021419
LAB Type Other - CHRNC DISEASE MGT CLINIC
Facility Name HEALTHSTAT ON-SITE CLINIC - COCA COLA
Street 4901 CHESAPEAKE DR
City CHARLOTTE
State NC
ZIP 28216
Phone 704 557-4615
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2025
Certificate Expiration Date 3/13/2027
Facility Type Other - CHRNC DISEASE MGT CLINIC
Lab Director DR. SANDRA SIMS

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This page was last updated on: 3/20/2025