34D2288996 CLIA NUMBER - COHEN CARE

Laboratory Demographics

CLIA Number: 34D2288996

Facility Name: COHEN CARE

Facility Address:
4915 ALBEMARLE ROAD
CHARLOTTE, NC
ZIP 28205
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Facility Phone Number: 704 780-7650

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1467131748

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	34D2288996
LAB Type	Physician Office
Facility Name	COHEN CARE
Street	4915 ALBEMARLE ROAD
City	CHARLOTTE
State	NC
ZIP	28205
Phone	704 780-7650
CertificateType	4
CertificateEffectiveDate	9/5/2023
CertificateExpirationDate	9/4/2025
FacilityType	Waiver

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