34D2278757 CLIA NUMBER - IREDELL URGENT CARE - STATESVILLE

Laboratory Demographics

  • CLIA Code: 34D2278757
  • Facility Name: IREDELL URGENT CARE - STATESVILLE
  • Facility Address: 1540 EAST BROAD STREET
    STATESVILLE, NC
    ZIP 28625
  • Facility Phone: 704 380-6900
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: JOHN NICHOLSON
  • NPI Number: 1053018648
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2278757
LAB Type Community Clinic
Facility Name IREDELL URGENT CARE - STATESVILLE
Street 1540 EAST BROAD STREET
City STATESVILLE
State NC
ZIP 28625
Phone 704 380-6900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Community Clinic
Lab Director JOHN NICHOLSON

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