34D1043499 CLIA NUMBER - MOUNTAINVIEW SKIN CARE PC

Laboratory Demographics

  • CLIA Code: 34D1043499
  • Facility Name: MOUNTAINVIEW SKIN CARE PC
  • Facility Address: 127 SOUTH POPLAR STREET
    WINSTON-SALEM, NC
    ZIP 27101
  • Facility Phone: 336 983-3230
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: PAUL D. WORTMAN
  • NPI Number: 1649492232
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D1043499
LAB Type Physician Office
Facility Name MOUNTAINVIEW SKIN CARE PC
Street 127 SOUTH POPLAR STREET
City WINSTON-SALEM
State NC
ZIP 27101
Phone 336 983-3230
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/26/2025
Certificate Expiration Date 7/25/2027
Facility Type Physician Office
Lab Director PAUL D. WORTMAN

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