34D2174067 CLIA NUMBER - ATRIUM HEALTH WAKE FOREST BAPTIST CLINIC AT FORSYTH COUNTY GOVERNMENT

Laboratory Demographics

  • CLIA Code: 34D2174067
  • Facility Name: ATRIUM HEALTH WAKE FOREST BAPTIST CLINIC AT FORSYTH COUNTY GOVERNMENT
  • Facility Address: 725 N HIGHLAND AVENUE
    WINSTON-SALEM, NC
    ZIP 27101
  • Facility Phone: 336 705-9573
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: STEVEN J. HAGEN
  • NPI Number: 1376117176
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 34D2174067
LAB Type Practitioner Other
Facility Name ATRIUM HEALTH WAKE FOREST BAPTIST CLINIC AT FORSYTH COUNTY GOVERNMENT
Street 725 N HIGHLAND AVENUE
City WINSTON-SALEM
State NC
ZIP 27101
Phone 336 705-9573
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2025
Certificate Expiration Date 10/22/2027
Facility Type Practitioner Other
Lab Director STEVEN J. HAGEN

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