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34D2210878 CLIA NUMBER - ATRIUM HEALTH WAKE FOREST BAPTIST CLINIC AT SAMARITANS PURSE N WILKESBORO

Laboratory Demographics

CLIA Number: 34D2210878

Facility Name: ATRIUM HEALTH WAKE FOREST BAPTIST CLINIC AT SAMARITANS PURSE N WILKESBORO

Facility Address:
118 WHITE PINE ST
NORTH WILKESBORO, NC
ZIP 28659
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Facility Phone Number: 336 409-7395

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1235546623

Taxonomy: 171M00000X - Case Manager/Care Coordinator
A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

CLIA Record

Field Name Field Value
CLIA Number 34D2210878
LAB Type Physician Office
Facility Name ATRIUM HEALTH WAKE FOREST BAPTIST CLINIC AT SAMARITANS PURSE N WILKESBORO
Street 118 WHITE PINE ST
City NORTH WILKESBORO
State NC
ZIP 28659
Phone 336 409-7395
CertificateType 4
CertificateEffectiveDate 1/25/2023
CertificateExpirationDate 1/24/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024