34D2312003 CLIA NUMBER - LEGACY HEALTH PA

Laboratory Demographics

  • CLIA Code: 34D2312003
  • Facility Name: LEGACY HEALTH PA
  • Facility Address: 3049 SENNA DRIVE
    MATTHEWS, NC
    ZIP 28105
  • Facility Phone: (980) 339-5155
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUSAN H. JERBY
  • NPI Number: 1780147108
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2312003
LAB Type Physician Office
Facility Name LEGACY HEALTH PA
Street 3049 SENNA DRIVE
City MATTHEWS
State NC
ZIP 28105
Phone 9803395155
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Physician Office
Lab Director SUSAN H. JERBY

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This page was last updated on: 6/29/2026