34D2142409 CLIA NUMBER - CAROLINA CENTER FOR RECOVERY

Laboratory Demographics

CLIA Number: 34D2142409

Facility Name: CAROLINA CENTER FOR RECOVERY

Facility Address:
7349 STATESVILLE RD
CHARLOTTE, NC
ZIP 28269
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Facility Phone Number: 704 844-6958

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Waiver

NPI Number: 1669989554

Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

CLIA Record

Field Name	Field Value
CLIA Number	34D2142409
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	CAROLINA CENTER FOR RECOVERY
Street	7349 STATESVILLE RD
City	CHARLOTTE
State	NC
ZIP	28269
Phone	704 844-6958
CertificateType	4
CertificateEffectiveDate	1/10/2024
CertificateExpirationDate	1/9/2026
FacilityType	Waiver

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