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34D2236576 CLIA NUMBER - JACKSON CONSULTING AND SERVICES

Laboratory Demographics

CLIA Number: 34D2236576

Facility Name: JACKSON CONSULTING AND SERVICES

Facility Address:
9008 BROAD RIDGE CT
CHARLOTTE, NC
ZIP 28269
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Facility Phone Number: 336 254-8677

Facility Type: Other - MH/SUBSTANCE ABUSE

Certificate Type: Waiver
NPI Number: 1033880059

Taxonomy: 291U00000X - Clinical Medical Laboratory
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

CLIA Record

Field Name Field Value
CLIA Number 34D2236576
LAB Type Other - MH/SUBSTANCE ABUSE
Facility Name JACKSON CONSULTING AND SERVICES
Street 9008 BROAD RIDGE CT
City CHARLOTTE
State NC
ZIP 28269
Phone 336 254-8677
CertificateType 4
CertificateEffectiveDate 9/17/2023
CertificateExpirationDate 9/16/2025
FacilityType Waiver

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