34D2296838 CLIA NUMBER - EDWARDS HEALTH, PLLC

Laboratory Demographics

CLIA Number: 34D2296838

Facility Name: EDWARDS HEALTH, PLLC

Facility Address:
4748 MAIN STREET
SHALLOTTE, NC
ZIP 28470
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Facility Phone Number: 910 537-5919

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1952178105

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2296838
LAB Type	Physician Office
Facility Name	EDWARDS HEALTH, PLLC
Street	4748 MAIN STREET
City	SHALLOTTE
State	NC
ZIP	28470
Phone	910 537-5919
CertificateType	4
CertificateEffectiveDate	1/5/2024
CertificateExpirationDate	1/4/2026
FacilityType	Waiver

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