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34D2122073 CLIA NUMBER - CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA

Laboratory Demographics

CLIA Number: 34D2122073

Facility Name: CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA

Facility Address:
144 FOUNTAIN PLACE
MOORESVILLE, NC
ZIP 28117
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Facility Phone Number: 704 658-0595

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1528423068

Taxonomy: 207Y00000X - Otolaryngology
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

CLIA Record

Field Name Field Value
CLIA Number 34D2122073
LAB Type Physician Office
Facility Name CHARLOTTE EYE EAR NOSE & THROAT ASSOCIATES, PA
Street 144 FOUNTAIN PLACE
City MOORESVILLE
State NC
ZIP 28117
Phone 704 658-0595
CertificateType 4
CertificateEffectiveDate 11/18/2022
CertificateExpirationDate 11/17/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024