34D2049565 CLIA NUMBER - PRIMARY CARE SOLUTIONS INC

Laboratory Demographics

CLIA Code: 34D2049565
Facility Name: PRIMARY CARE SOLUTIONS INC
Facility Address: 5601 EXECUTIVE CENTER DRIVE, SUITE 200
CHARLOTTE, NC
ZIP 28212
Facility Phone: 704 537-1022
Facility Type: Comp. Outpatient Rehab Facility
Facility Type: Waiver
Lab Director: WILLIAM A. BULLOCK
NPI Number: 1518009992
Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness

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CLIA Record

Field Name	Field Value
CLIA Number	34D2049565
LAB Type	Comp. Outpatient Rehab Facility
Facility Name	PRIMARY CARE SOLUTIONS INC
Street	5601 EXECUTIVE CENTER DRIVE, SUITE 200
City	CHARLOTTE
State	NC
ZIP	28212
Phone	704 537-1022
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	11/8/2024
Certificate Expiration Date	11/7/2026
Facility Type	Comp. Outpatient Rehab Facility
Lab Director	WILLIAM A. BULLOCK

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This page was last updated on: 9/29/2025