34D2130099 CLIA NUMBER - LEVINE CHILDREN'S SPECIALTY CENTER

Laboratory Demographics

  • CLIA Code: 34D2130099
  • Facility Name: LEVINE CHILDREN'S SPECIALTY CENTER
  • Facility Address: 1001 BLYTHE BOULEVARD, SUITE 200-MCP
    CHARLOTTE, NC
    ZIP 28203
  • Facility Phone: 704 381-8840
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SUSAN MASSENGILL
  • NPI Number: 1699829887
  • Taxonomy: 283XC2000X - Rehabilitation Hospital

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CLIA Record

Field Name Field Value
CLIA Number 34D2130099
LAB Type Physician Office
Facility Name LEVINE CHILDREN'S SPECIALTY CENTER
Street 1001 BLYTHE BOULEVARD, SUITE 200-MCP
City CHARLOTTE
State NC
ZIP 28203
Phone 704 381-8840
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 5/2/2025
Certificate Expiration Date 5/1/2027
Facility Type Physician Office
Lab Director SUSAN MASSENGILL

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