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WELLNESS CTR. STUDENT BLUE
NPI 1851713374
Clinic/Center - Student Health in Winston Salem, NC

Active since January 17, 2014CLIA 34D0904030 · Microscopy
601 S MARTIN LUTHER KING JR DR, A.H. RAY BLDG RM. 244, WINSTON SALEM, NC 27110(336) 750-3301(336) 750-3303 Get Directions Write a Review

NPPES record last updated: January 17, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Wellness Ctr. Student Blue NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WELLNESS CTR. STUDENT BLUE (NPI 1851713374) is a healthcare organization registered as a student health in Winston Salem, North Carolina and active in the NPI registry since January 2014. The organization holds a CLIA Microscopy certificate valid through May 1, 2028 and lists Anthony Philadelphia, Director, as its authorized official.

NPPES Registry Identity

NPI1851713374
Entity TypeOrganization
Primary Taxonomy261QS1000X
Legal Business NameWINSTON-SALEM STATE UNIVERSITY
Location Address601 S MARTIN LUTHER KING JR DR, A.H. RAY BLDG RM. 244Winston Salem, NC 27110-0001
Mailing Address601 S Martin Luther King Jr Dr, A.h. Ray Bldg Rm. 244Winston Salem, NC 27110-0001 · (336) 750-3301 · Fax (336) 750-3303
Phone(336) 750-3301
Fax(336) 750-3303
Organization SubpartNo
Authorized OfficialAnthony PhiladelphiaDirector · (336) 750-3274
Enumeration DateJanuary 17, 2014
✔ NPI 1851713374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Student HealthAmbulatory Health Care Facilities
Taxonomy Code261QS1000X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
601 S MARTIN LUTHER KING JR DR, Winston Salem, NC 27110
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Other Names 1

Other NameWellness Ctr. Student Blue

Other Identifiers 2

Medicare UPIN2594534NC
Medicaid7000169NC

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 34D0904030

Winston Salem State University Wellness Center · Winston Salem, NC
Active · expires May 1, 2028
CLIA Number34D0904030
Laboratory TypeSchool/Student Health Service
Certificate Effective DateMay 2, 2026
Certificate Expiration DateMay 1, 2028
Laboratory DirectorKaren T. Williams
Laboratory Phone(336) 750-3301
Laboratory LocationWinston Salem State University Wellness Center601 S Martin Luther King Jr Drive, Winston Salem, NC 27110
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DARRELL MATTHEW TURNER M.ED., ATC
Specialist/Technologist (Athletic Trainer)
601 S MARTIN LUTHER KING JR DR
WINSTON SALEM, NC 27110
Forsyth County (336) 750-2597
MRS. ADEBOLA OMOLARA ILESANMI FNP
Nurse Practitioner (Family)
601 S MARTIN LUTHER KING JR DR, ROOM 244
WINSTON SALEM, NC 27110
Forsyth County (336) 750-3300
YOLANDA JEAN RAINEY P.T., DPT
Physical Therapist
601 S MARTIN LUTHER KING JR DR, RM. 340 F.L. ATKINS BLDG.
WINSTON SALEM, NC 27110
Forsyth County (336) 750-2198
WINSTON SALEM STATE UNIVERSITY, A. H. RAY STUDENT HEALTH SERVICE
Clinic/Center (Student Health)
601 S MARTIN LUTHER KING JR DR, RM 244, A. H. RAY BUILDING
WINSTON SALEM, NC 27110
Forsyth County (336) 750-3300
WINSTON SALEM STATE UNIVERSITY
Pharmacy (Community/Retail Pharmacy)
601 S MARTIN LUTHER KING JR DR, SUITE 244
WINSTON SALEM, NC 27110
Forsyth County (336) 750-3376
GRACE ALEXANDRA TEDDER
Student in an Organized Health Care Education/Training Program
601 S MARTIN LUTHER KING JR DR
WINSTON SALEM, NC 27110
Forsyth County (336) 750-2000
SAVANNAH K DORMAN
Occupational Therapist
601 S MARTIN LUTHER KING JR DR
WINSTON SALEM, NC 27110
Forsyth County (336) 750-2000
GREYSON RAY
Student in an Organized Health Care Education/Training Program
601 S MARTIN LUTHER KING JR DR
WINSTON SALEM, NC 27110
Forsyth County (336) 750-2000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Winston-Salem State University's NPI number?

The NPI number for Winston-Salem State University is 1851713374. It was assigned to this organization in the NPPES registry on January 17, 2014.

Where is Winston-Salem State University located?

Winston-Salem State University is located at 601 S Martin Luther King Jr Dr A.H. Ray Bldg Rm. 244, Winston Salem, NC 27110. The listed phone number is (336) 750-3301.

What is Winston-Salem State University's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Student Health, with taxonomy code 261QS1000X.

Does Winston-Salem State University hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 34D0904030) is associated with this NPI, valid through May 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Winston-Salem State University was last updated on January 17, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.