34D1096202 CLIA NUMBER - LEBAUER ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 34D1096202
  • Facility Name: LEBAUER ENDOSCOPY CENTER
  • Facility Address: 520 NORTH ELAM AVE, 4TH FLOOR
    GREENSBORO, NC
    ZIP 27403
  • Facility Phone: 336 547-1718
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: KAVITHA NANDIGAM
  • NPI Number: 1194744532
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D1096202
LAB Type Ambulatory Surgery Center
Facility Name LEBAUER ENDOSCOPY CENTER
Street 520 NORTH ELAM AVE, 4TH FLOOR
City GREENSBORO
State NC
ZIP 27403
Phone 336 547-1718
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2025
Certificate Expiration Date 2/26/2027
Facility Type Ambulatory Surgery Center
Lab Director KAVITHA NANDIGAM

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