34D2182701 CLIA NUMBER - TRIAD BEHAVIORAL RESOURCES, PC

Laboratory Demographics

  • CLIA Code: 34D2182701
  • Facility Name: TRIAD BEHAVIORAL RESOURCES, PC
  • Facility Address: 1050 REVOLUTION MILL DR, SUITE 7 STUDIO A
    GREENSBORO, NC
    ZIP 27405
  • Facility Phone: 910 765-1003
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: KEIVAN A. ETTEFAGH
  • NPI Number: 1336292556
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 34D2182701
LAB Type Physician Office
Facility Name TRIAD BEHAVIORAL RESOURCES, PC
Street 1050 REVOLUTION MILL DR, SUITE 7 STUDIO A
City GREENSBORO
State NC
ZIP 27405
Phone 910 765-1003
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/15/2023
Certificate Expiration Date 12/14/2025
Facility Type Physician Office
Lab Director KEIVAN A. ETTEFAGH

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