34D2131699 CLIA NUMBER - CHESTNUT FAMILY PRACTICE, PLLC

Laboratory Demographics

  • CLIA Code: 34D2131699
  • Facility Name: CHESTNUT FAMILY PRACTICE, PLLC
  • Facility Address: 1013 CHESTNUT LANE, SUITE 110
    MATTHEWS, NC
    ZIP 28104
  • Facility Phone: 704 585-8255
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SUSAN E. LADD-SNIVELY
  • NPI Number: 1134654338
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2131699
LAB Type Physician Office
Facility Name CHESTNUT FAMILY PRACTICE, PLLC
Street 1013 CHESTNUT LANE, SUITE 110
City MATTHEWS
State NC
ZIP 28104
Phone 704 585-8255
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 6/5/2025
Certificate Expiration Date 6/4/2027
Facility Type Physician Office
Lab Director SUSAN E. LADD-SNIVELY

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