34D1048740 CLIA NUMBER - CHMG PEDIATRIC SPECIALIST MOSES CONE PHYSICIAN SERVICES

Laboratory Demographics

  • CLIA Code: 34D1048740
  • Facility Name: CHMG PEDIATRIC SPECIALIST MOSES CONE PHYSICIAN SERVICES
  • Facility Address: WENDOVER MEDICAL BLDG STE 311 301 EAST WENDOVER AVE
    GREENSBORO, NC
    ZIP 27401
  • Facility Phone: 336 272-6161
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL J. BRENNAN MD
  • NPI Number: 1164949814
  • Taxonomy: 2084N0402X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 34D1048740
LAB Type Physician Office
Facility Name CHMG PEDIATRIC SPECIALIST MOSES CONE PHYSICIAN SERVICES
Street WENDOVER MEDICAL BLDG STE 311 301 EAST WENDOVER AVE
City GREENSBORO
State NC
ZIP 27401
Phone 336 272-6161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2023
Certificate Expiration Date 12/8/2025
Facility Type Physician Office
Lab Director MICHAEL J. BRENNAN MD

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