34D2320502 CLIA NUMBER - LAKESIDE INTEGRATIVE HEALTHCARE

Laboratory Demographics

  • CLIA Code: 34D2320502
  • Facility Name: LAKESIDE INTEGRATIVE HEALTHCARE
  • Facility Address: 11220 TREYNORTH DRIVE SUITE A
    CORNELIUS, NC
    ZIP 28031
  • Facility Phone: 704 896-8446
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEVIN CORRIGAN
  • NPI Number: 1033125240
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2320502
LAB Type Physician Office
Facility Name LAKESIDE INTEGRATIVE HEALTHCARE
Street 11220 TREYNORTH DRIVE SUITE A
City CORNELIUS
State NC
ZIP 28031
Phone 704 896-8446
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Physician Office
Lab Director KEVIN CORRIGAN

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