34D2089092 CLIA NUMBER - ATRIUM HEALTH CHILDREN'S SPECIALTY NETWORK, INC

Laboratory Demographics

  • CLIA Code: 34D2089092
  • Facility Name: ATRIUM HEALTH CHILDREN'S SPECIALTY NETWORK, INC
  • Facility Address: 1781 TATE BOULEVARD, SE, SUITE 203
    HICKORY, NC
    ZIP 28602
  • Facility Phone: (704) 381-3950
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK R. VANDERWELL
  • NPI Number: 1962218057
  • Taxonomy: 2080P0205X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 34D2089092
LAB Type Physician Office
Facility Name ATRIUM HEALTH CHILDREN'S SPECIALTY NETWORK, INC
Street 1781 TATE BOULEVARD, SE, SUITE 203
City HICKORY
State NC
ZIP 28602
Phone 7043813950
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2024
Certificate Expiration Date 12/17/2026
Facility Type Physician Office
Lab Director MARK R. VANDERWELL

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This page was last updated on: 5/18/2026