34D1019565 CLIA NUMBER - WAKE FOREST UNIVERSITY HEALTH SCIENCES

Laboratory Demographics

  • CLIA Code: 34D1019565
  • Facility Name: WAKE FOREST UNIVERSITY HEALTH SCIENCES
  • Facility Address: 4TH FL ARDMORE TOWER WEST MEDICAL CENTER BLVD
    WINSTON SALEM, NC
    ZIP 27157
  • Facility Phone: 336 713-4432
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: ROBERT J. APPLEGATE
  • NPI Number: 1275071482
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 34D1019565
LAB Type Ancillary Testing Site in Health Care Center
Facility Name WAKE FOREST UNIVERSITY HEALTH SCIENCES
Street 4TH FL ARDMORE TOWER WEST MEDICAL CENTER BLVD
City WINSTON SALEM
State NC
ZIP 27157
Phone 336 713-4432
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2023
Certificate Expiration Date 11/20/2025
Facility Type Ancillary Testing Site in Health Care Center
Lab Director ROBERT J. APPLEGATE

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