34D2266970 CLIA NUMBER - ATRIUM HEALTH WAKE FOREST BAPTIST OCC MEDICINE KERNERSVILLE

Laboratory Demographics

  • CLIA Code: 34D2266970
  • Facility Name: ATRIUM HEALTH WAKE FOREST BAPTIST OCC MEDICINE KERNERSVILLE
  • Facility Address: 109 GATEWAY DRIVE
    KERNERSVILLE, NC
    ZIP 27284
  • Facility Phone: 336 705-4317
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: STEVEN J. HAGEN
  • NPI Number: 1922434307
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D2266970
LAB Type Practitioner Other
Facility Name ATRIUM HEALTH WAKE FOREST BAPTIST OCC MEDICINE KERNERSVILLE
Street 109 GATEWAY DRIVE
City KERNERSVILLE
State NC
ZIP 27284
Phone 336 705-4317
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2024
Certificate Expiration Date 8/17/2026
Facility Type Practitioner Other
Lab Director STEVEN J. HAGEN

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