34D2315198 CLIA NUMBER - PRESTIGE LAB SERVICES

Laboratory Demographics

  • CLIA Code: 34D2315198
  • Facility Name: PRESTIGE LAB SERVICES
  • Facility Address: 219 W MAIN AVE SUITE 1
    GASTONIA, NC
    ZIP 28052
  • Facility Phone: 888 302-2235
  • Facility Type: Other - DIAGNOSTIC LAB
  • Facility Type: Waiver
  • Lab Director: TAMEIKA TATE
  • NPI Number: 1457164576
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2315198
LAB Type Other - DIAGNOSTIC LAB
Facility Name PRESTIGE LAB SERVICES
Street 219 W MAIN AVE SUITE 1
City GASTONIA
State NC
ZIP 28052
Phone 888 302-2235
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2024
Certificate Expiration Date 12/8/2026
Facility Type Other - DIAGNOSTIC LAB
Lab Director TAMEIKA TATE

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This page was last updated on: 9/29/2025