34D2317670 CLIA NUMBER - CHARLOTTE DETOX CENTER

Laboratory Demographics

  • CLIA Code: 34D2317670
  • Facility Name: CHARLOTTE DETOX CENTER
  • Facility Address: 7349 STATESVILLE RD
    CHARLOTTE, NC
    ZIP 28269
  • Facility Phone: 866 797-7962
  • Facility Type: Other - DETOX CENTER
  • Facility Type: Waiver
  • Lab Director: RYAN LEDOUX
  • NPI Number: 1215679121
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2317670
LAB Type Other - DETOX CENTER
Facility Name CHARLOTTE DETOX CENTER
Street 7349 STATESVILLE RD
City CHARLOTTE
State NC
ZIP 28269
Phone 866 797-7962
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/29/2025
Certificate Expiration Date 1/28/2027
Facility Type Other - DETOX CENTER
Lab Director RYAN LEDOUX

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