34D2246051 CLIA NUMBER - ATRIUM HEALTH COMMUNITY CARE PRIMARY CARE ARCHDALE FAMILY MED

Laboratory Demographics

  • CLIA Code: 34D2246051
  • Facility Name: ATRIUM HEALTH COMMUNITY CARE PRIMARY CARE ARCHDALE FAMILY MED
  • Facility Address: 5929 SOUTH BOULEVARD
    CHARLOTTE, NC
    ZIP 28217
  • Facility Phone: 704 667-5160
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CORDULA F. DAVIS
  • NPI Number: 1962042416
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D2246051
LAB Type Physician Office
Facility Name ATRIUM HEALTH COMMUNITY CARE PRIMARY CARE ARCHDALE FAMILY MED
Street 5929 SOUTH BOULEVARD
City CHARLOTTE
State NC
ZIP 28217
Phone 704 667-5160
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Physician Office
Lab Director CORDULA F. DAVIS

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