34D2128503 CLIA NUMBER - MIDWAY

Laboratory Demographics

  • CLIA Code: 34D2128503
  • Facility Name: MIDWAY
  • Facility Address: 12518 OLD HIGHWAY 52 NORTH
    WINSTON-SALEM, NC
    ZIP 27107
  • Facility Phone: 336 224-2923
  • Facility Type: Other - SUPERVISED ADULT FACILITY
  • Facility Type: Waiver
  • Lab Director: MICHAEL HEADEN
  • NPI Number: 1124330535
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 34D2128503
LAB Type Other - SUPERVISED ADULT FACILITY
Facility Name MIDWAY
Street 12518 OLD HIGHWAY 52 NORTH
City WINSTON-SALEM
State NC
ZIP 27107
Phone 336 224-2923
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Other - SUPERVISED ADULT FACILITY
Lab Director MICHAEL HEADEN

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