34D2029953 CLIA NUMBER - MRI SPECIALIST OF CAROLINAS

Laboratory Demographics

  • CLIA Code: 34D2029953
  • Facility Name: MRI SPECIALIST OF CAROLINAS
  • Facility Address: 620 SUMMIT CROSSING, STE 106
    GASTONIA, NC
    ZIP 28054
  • Facility Phone: 704 834-2885
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: MARK EDGE MD
  • NPI Number: 1154854503
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 34D2029953
LAB Type Mobile Laboratory
Facility Name MRI SPECIALIST OF CAROLINAS
Street 620 SUMMIT CROSSING, STE 106
City GASTONIA
State NC
ZIP 28054
Phone 704 834-2885
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2023
Certificate Expiration Date 9/18/2025
Facility Type Mobile Laboratory
Lab Director MARK EDGE MD

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This page was last updated on: 6/4/2025