Amends GS 131E-176 to delete the definition for diagnostic center. Makes a conforming change. Adds a definition for single-specialty ambulatory operating room, which is also designated as a new institutional health service. Amends GS 131E-178 to clarify the law requiring ambulatory surgical facilities providing gastrointestinal endoscopy procedures to obtain a certificate of need (CON), unless exempted from the requirement. Directs any person proposing to create single-specialty ambulatory operating rooms in an ambulatory surgery facility to obtain a CON, unless exempted. Amends GS 131E-182 to update the application procedures for establishing such single-specialty ambulatory operating rooms; makes these revisions expire when conforming administrative rules are adopted. Adds in GS 131E-184(a), as a reason for exempting a new institutional health service from CON review, the development or replacement of an institutional health service that received CON approval as a diagnostic center before the act's effective date. Adds General Assembly findings concerning CONs to GS 131E-175.