34D2323987 CLIA NUMBER - CENTRO MEDICO LATINO

Laboratory Demographics

  • CLIA Code: 34D2323987
  • Facility Name: CENTRO MEDICO LATINO
  • Facility Address: 3623 SOUTH BLVD, SUITE E
    CHARLOTTE, NC
    ZIP 28217
  • Facility Phone: 704 333-0465
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CARLOS M. RISH
  • NPI Number: 1164884821
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D2323987
LAB Type Physician Office
Facility Name CENTRO MEDICO LATINO
Street 3623 SOUTH BLVD, SUITE E
City CHARLOTTE
State NC
ZIP 28217
Phone 704 333-0465
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2025
Certificate Expiration Date 5/15/2027
Facility Type Physician Office
Lab Director CARLOS M. RISH

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