34D2104339 CLIA NUMBER - PIEDMONT RESIDENTIAL DEVELOPMENT CENTER

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CLIA Record

Field Name Field Value
CLIA Number 34D2104339
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name PIEDMONT RESIDENTIAL DEVELOPMENT CENTER
Street 5300 HIGHWAY 200
City CONCORD
State NC
ZIP 28025
Phone 704 788-2304
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director DAVID PAVELOCK

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