34D2217058 CLIA NUMBER - UNCG ATHLETIC TRAINING ROOM

Laboratory Demographics

CLIA Number: 34D2217058

Facility Name: UNCG ATHLETIC TRAINING ROOM

Facility Address:
1408 WALKER AVENUE COLEMAN BUILDING #136E
GREENSBORO, NC
ZIP 27412
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Facility Phone Number: 336 904-3557

Facility Type: School/Student Health Service

Certificate Type: Waiver

NPI Number: 1992254114

Taxonomy: 101YP2500X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	34D2217058
LAB Type	School/Student Health Service
Facility Name	UNCG ATHLETIC TRAINING ROOM
Street	1408 WALKER AVENUE COLEMAN BUILDING #136E
City	GREENSBORO
State	NC
ZIP	27412
Phone	336 904-3557
CertificateType	4
CertificateEffectiveDate	3/18/2023
CertificateExpirationDate	3/17/2025
FacilityType	Waiver

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