34D2168107 CLIA NUMBER - VERITAS COLLABORATIVE CHARLOTTE, LLC

Laboratory Demographics

CLIA Number: 34D2168107

Facility Name: VERITAS COLLABORATIVE CHARLOTTE, LLC

Facility Address:
1900 SCOTT AVENUE, SUITE 101
CHARLOTTE, NC
ZIP 28203
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Facility Phone Number: 704 680-3140

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1891330056

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2168107
LAB Type	Physician Office
Facility Name	VERITAS COLLABORATIVE CHARLOTTE, LLC
Street	1900 SCOTT AVENUE, SUITE 101
City	CHARLOTTE
State	NC
ZIP	28203
Phone	704 680-3140
CertificateType	4
CertificateEffectiveDate	6/20/2023
CertificateExpirationDate	6/19/2025
FacilityType	Waiver

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