34D2284268 CLIA NUMBER - NOVANT HEALTH CANCER INSTITUTE - GREENSBOBO MEDICAL ONCOLOGY

Laboratory Demographics

CLIA Number: 34D2284268

Facility Name: NOVANT HEALTH CANCER INSTITUTE - GREENSBOBO MEDICAL ONCOLOGY

Facility Address:
3515 W MARKET ST, SUITE 300
GREENSBORO, NC
ZIP 27403
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Facility Phone Number: 336 564-4170

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1073823118

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	34D2284268
LAB Type	Physician Office
Facility Name	NOVANT HEALTH CANCER INSTITUTE - GREENSBOBO MEDICAL ONCOLOGY
Street	3515 W MARKET ST, SUITE 300
City	GREENSBORO
State	NC
ZIP	27403
Phone	336 564-4170
CertificateType	2
CertificateEffectiveDate	11/2/2023
CertificateExpirationDate	11/1/2025
FacilityType	Compliance

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