34D1059373 CLIA NUMBER - PATHOLOGISTS DIAGNOSTIC LABORATORY, PA

Laboratory Demographics

  • CLIA Code: 34D1059373
  • Facility Name: PATHOLOGISTS DIAGNOSTIC LABORATORY, PA
  • Facility Address: 1800 SOUTH HAWTHORNE ROAD, SUITE 100
    WINSTON-SALEM, NC
    ZIP 27103
  • Facility Phone: 336 306-5777
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: TIM D. WAX
  • NPI Number: 1942278411
  • Taxonomy: 207ZP0102X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 34D1059373
LAB Type Independent
Facility Name PATHOLOGISTS DIAGNOSTIC LABORATORY, PA
Street 1800 SOUTH HAWTHORNE ROAD, SUITE 100
City WINSTON-SALEM
State NC
ZIP 27103
Phone 336 306-5777
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Independent
Lab Director TIM D. WAX

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