34D2189972 CLIA NUMBER - FORSYTH PLASTIC SURGERY ASSOCIATES

Laboratory Demographics

  • CLIA Code: 34D2189972
  • Facility Name: FORSYTH PLASTIC SURGERY ASSOCIATES
  • Facility Address: 2901 MAPLEWOOD AVENUE
    WINSTON SALEM, NC
    ZIP 27103
  • Facility Phone: 336 765-8620
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SUSAN F. COX
  • NPI Number: 1811090475
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 34D2189972
LAB Type Ambulatory Surgery Center
Facility Name FORSYTH PLASTIC SURGERY ASSOCIATES
Street 2901 MAPLEWOOD AVENUE
City WINSTON SALEM
State NC
ZIP 27103
Phone 336 765-8620
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2024
Certificate Expiration Date 8/6/2026
Facility Type Ambulatory Surgery Center
Lab Director SUSAN F. COX

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