34D2234285 CLIA NUMBER - LOGICAL MOBILE LABORATORY

Laboratory Demographics

  • CLIA Code: 34D2234285
  • Facility Name: LOGICAL MOBILE LABORATORY
  • Facility Address: 1030 ALLEGIANCE DR
    CHARLOTTE, NC
    ZIP 28217
  • Facility Phone: 704 773-7475
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: SABRINA HICKENBOTHAM
  • NPI Number: 1972277572
  • Taxonomy: 246R00000X - Technician, Pathology

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CLIA Record

Field Name Field Value
CLIA Number 34D2234285
LAB Type Mobile Laboratory
Facility Name LOGICAL MOBILE LABORATORY
Street 1030 ALLEGIANCE DR
City CHARLOTTE
State NC
ZIP 28217
Phone 704 773-7475
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2025
Certificate Expiration Date 8/29/2027
Facility Type Mobile Laboratory
Lab Director SABRINA HICKENBOTHAM

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