34D2112309 CLIA NUMBER - MARATHON HEALTH AT 4TH & MCDOWELL

Laboratory Demographics

  • CLIA Code: 34D2112309
  • Facility Name: MARATHON HEALTH AT 4TH & MCDOWELL
  • Facility Address: 901 E 4TH STREET, SUITE D
    CHARLOTTE, NC
    ZIP 28204
  • Facility Phone: 866 434-3255
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LLOYD BRIDGES
  • NPI Number: 1174248413
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 34D2112309
LAB Type Physician Office
Facility Name MARATHON HEALTH AT 4TH & MCDOWELL
Street 901 E 4TH STREET, SUITE D
City CHARLOTTE
State NC
ZIP 28204
Phone 866 434-3255
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/27/2024
Certificate Expiration Date 4/26/2026
Facility Type Physician Office
Lab Director LLOYD BRIDGES

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