34D2130271 CLIA NUMBER - KATHRYN E LONG, MD, PLLC

Laboratory Demographics

CLIA Number: 34D2130271

Facility Name: KATHRYN E LONG, MD, PLLC

Facility Address:
8731 RED OAK BLVD, SUITE 100
CHARLOTTE, NC
ZIP 28217
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Facility Phone Number: 704 910-2250

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1083623672

Taxonomy: 207QA0505X - Family Medicine
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

CLIA Record

Field Name	Field Value
CLIA Number	34D2130271
LAB Type	Physician Office
Facility Name	KATHRYN E LONG, MD, PLLC
Street	8731 RED OAK BLVD, SUITE 100
City	CHARLOTTE
State	NC
ZIP	28217
Phone	704 910-2250
CertificateType	4
CertificateEffectiveDate	5/5/2023
CertificateExpirationDate	5/4/2025
FacilityType	Waiver

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