34D2298586 CLIA NUMBER - KINTEGRA DENTISTRY FAMILY - HICKORY

Laboratory Demographics

CLIA Number: 34D2298586

Facility Name: KINTEGRA DENTISTRY FAMILY - HICKORY

Facility Address:
3070 11TH AVE DR
HICKORY, NC
ZIP 28602
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Facility Phone Number: 704 874-1954

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1972163848

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2298586
LAB Type	Federally Qualified Health Center
Facility Name	KINTEGRA DENTISTRY FAMILY - HICKORY
Street	3070 11TH AVE DR
City	HICKORY
State	NC
ZIP	28602
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