34D0966565 CLIA NUMBER - EAGLE PHYSICIAN GASTROENTEROLOGY

Laboratory Demographics

  • CLIA Code: 34D0966565
  • Facility Name: EAGLE PHYSICIAN GASTROENTEROLOGY
  • Facility Address: 1002 N CHURCH STREET, SUITE 201
    GREENSBORO, NC
    ZIP 27401
  • Facility Phone: 336 268-3400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PARAG BRAHMBHATT
  • NPI Number: 1073698502
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D0966565
LAB Type Physician Office
Facility Name EAGLE PHYSICIAN GASTROENTEROLOGY
Street 1002 N CHURCH STREET, SUITE 201
City GREENSBORO
State NC
ZIP 27401
Phone 336 268-3400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2023
Certificate Expiration Date 10/19/2025
Facility Type Physician Office
Lab Director PARAG BRAHMBHATT

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