34D1106660 CLIA NUMBER - NCBH OUTPATIENT ENDOSCOPY CENTER LLC

Laboratory Demographics

  • CLIA Code: 34D1106660
  • Facility Name: NCBH OUTPATIENT ENDOSCOPY CENTER LLC
  • Facility Address: 101 CHARLOIS BLVD STE 100
    WINSTON SALEM, NC
    ZIP 27103
  • Facility Phone: 336 713-0330
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MISHRA GIRISH
  • NPI Number: 1215263082
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D1106660
LAB Type Ambulatory Surgery Center
Facility Name NCBH OUTPATIENT ENDOSCOPY CENTER LLC
Street 101 CHARLOIS BLVD STE 100
City WINSTON SALEM
State NC
ZIP 27103
Phone 336 713-0330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2023
Certificate Expiration Date 10/19/2025
Facility Type Ambulatory Surgery Center
Lab Director MISHRA GIRISH

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