34D2127974 CLIA NUMBER - BETHANY MEDICAL AND PAIN CLINIC

Laboratory Demographics

  • CLIA Code: 34D2127974
  • Facility Name: BETHANY MEDICAL AND PAIN CLINIC
  • Facility Address: 160 KIMEL FOREST DRIVE, SUITE 100
    WINSTON-SALEM, NC
    ZIP 27103
  • Facility Phone: 336 883-0029
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WAYNE BEAUFORD
  • NPI Number: 1528525839
  • Taxonomy: 363L00000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D2127974
LAB Type Physician Office
Facility Name BETHANY MEDICAL AND PAIN CLINIC
Street 160 KIMEL FOREST DRIVE, SUITE 100
City WINSTON-SALEM
State NC
ZIP 27103
Phone 336 883-0029
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Physician Office
Lab Director WAYNE BEAUFORD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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