34D2298585 CLIA NUMBER - KINTEGRA FAMILY DENTISTRY - LINCOLNTON

Laboratory Demographics

CLIA Number: 34D2298585

Facility Name: KINTEGRA FAMILY DENTISTRY - LINCOLNTON

Facility Address:
111 DOCTORS PARK
LINCOLNTON, NC
ZIP 28092
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Facility Phone Number: 704 874-1954

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1568092658

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2298585
LAB Type	Federally Qualified Health Center
Facility Name	KINTEGRA FAMILY DENTISTRY - LINCOLNTON
Street	111 DOCTORS PARK
City	LINCOLNTON
State	NC
ZIP	28092
Phone	704 874-1954
CertificateType	4
CertificateEffectiveDate	2/5/2024
CertificateExpirationDate	2/4/2026
FacilityType	Waiver

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