34D2062115 CLIA NUMBER - NOVANT HEALTH WALLBURG FAMILY MEDICINE

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Laboratory Demographics

CLIA Number: 34D2062115

Facility Name: NOVANT HEALTH WALLBURG FAMILY MEDICINE

Facility Address:
10479 NORTH NC HIGHWAY 109, SUITE 107A
WINSTON SALEM, NC
ZIP 27107
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Facility Phone Number: 336 769-0246

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1225475023

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	34D2062115
LAB Type	Physician Office
Facility Name	NOVANT HEALTH WALLBURG FAMILY MEDICINE
Street	10479 NORTH NC HIGHWAY 109, SUITE 107A
City	WINSTON SALEM
State	NC
ZIP	27107
Phone	336 769-0246
CertificateType	4
CertificateEffectiveDate	4/23/2023
CertificateExpirationDate	4/22/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024