34D2156916 CLIA NUMBER - QUEEN CITY GASTROENTEROLOGY AND HEPATOLOGY, PC

Laboratory Demographics

CLIA Number: 34D2156916

Facility Name: QUEEN CITY GASTROENTEROLOGY AND HEPATOLOGY, PC

Facility Address:
320 LILLINGTON AVENUE, SUITE 101
CHARLOTTE, NC
ZIP 28204
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Facility Phone Number: 704 319-0396

Facility Type: Independent

Certificate Type: Certificate of Compliance

NPI Number: 1750682431

Taxonomy: 207RG0100X - Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

CLIA Record

Field Name	Field Value
CLIA Number	34D2156916
LAB Type	Independent
Facility Name	QUEEN CITY GASTROENTEROLOGY AND HEPATOLOGY, PC
Street	320 LILLINGTON AVENUE, SUITE 101
City	CHARLOTTE
State	NC
ZIP	28204
Phone	704 319-0396
CertificateType	2
CertificateEffectiveDate	11/15/2021
CertificateExpirationDate	4/30/2024
FacilityType	Compliance

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