34D2290994 CLIA NUMBER - ATRIUM HEALTH WAKE FOREST BAPTIST CLINIC AT RANDOLPH COUNTY GOVERNMENT

Laboratory Demographics

  • CLIA Code: 34D2290994
  • Facility Name: ATRIUM HEALTH WAKE FOREST BAPTIST CLINIC AT RANDOLPH COUNTY GOVERNMENT
  • Facility Address: 1467 N. FAYETTEVILLE STREET
    ASHEBORO, NC
    ZIP 27203
  • Facility Phone: 336 705-9573
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. STEVEN J. HAGEN
  • NPI Number: 1588859466
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 34D2290994
LAB Type Practitioner Other
Facility Name ATRIUM HEALTH WAKE FOREST BAPTIST CLINIC AT RANDOLPH COUNTY GOVERNMENT
Street 1467 N. FAYETTEVILLE STREET
City ASHEBORO
State NC
ZIP 27203
Phone 336 705-9573
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2025
Certificate Expiration Date 10/3/2027
Facility Type Practitioner Other
Lab Director DR. STEVEN J. HAGEN

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