34D2235570 CLIA NUMBER - THE SHALOM PROJECT MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 34D2235570
  • Facility Name: THE SHALOM PROJECT MEDICAL CLINIC
  • Facility Address: 3185 MAPLEWOOD AVE
    WINSTON-SALEM, NC
    ZIP 27103
  • Facility Phone: 336 721-0606
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: STEPHEN G. BISSETTE
  • NPI Number: 1831883081
  • Taxonomy: 3336C0002X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 34D2235570
LAB Type Community Clinic
Facility Name THE SHALOM PROJECT MEDICAL CLINIC
Street 3185 MAPLEWOOD AVE
City WINSTON-SALEM
State NC
ZIP 27103
Phone 336 721-0606
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2025
Certificate Expiration Date 9/9/2027
Facility Type Community Clinic
Lab Director STEPHEN G. BISSETTE

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