34D2185264 CLIA NUMBER - RANDOLPH MEDICAL PHARMACY

Laboratory Demographics

  • CLIA Code: 34D2185264
  • Facility Name: RANDOLPH MEDICAL PHARMACY
  • Facility Address: 3541 RANDOLPH ROAD SUITE 104
    CHARLOTTE, NC
    ZIP 28211
  • Facility Phone: 704 365-0707
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KUNTAL LALA
  • NPI Number: 1083739254
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2185264
LAB Type Pharmacy
Facility Name RANDOLPH MEDICAL PHARMACY
Street 3541 RANDOLPH ROAD SUITE 104
City CHARLOTTE
State NC
ZIP 28211
Phone 704 365-0707
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2024
Certificate Expiration Date 6/1/2026
Facility Type Pharmacy
Lab Director KUNTAL LALA

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