34D1007881 CLIA NUMBER - AHWFB PEDIATRICS KERNERSVILLE MAIN STREET

Laboratory Demographics

  • CLIA Code: 34D1007881
  • Facility Name: AHWFB PEDIATRICS KERNERSVILLE MAIN STREET
  • Facility Address: 861 OLD WINSTON ROAD, SUITE 101
    KERNERSVILLE, NC
    ZIP 27284
  • Facility Phone: 336 713-0990
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: REBECCA P. BALL
  • NPI Number: 1700490232
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D1007881
LAB Type Physician Office
Facility Name AHWFB PEDIATRICS KERNERSVILLE MAIN STREET
Street 861 OLD WINSTON ROAD, SUITE 101
City KERNERSVILLE
State NC
ZIP 27284
Phone 336 713-0990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2025
Certificate Expiration Date 5/16/2027
Facility Type Physician Office
Lab Director REBECCA P. BALL

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