49D1107436 CLIA NUMBER - BALLAD HEALTH MEDICAL ASSOCIATES FAMILY MEDICINE EXIT 7

Laboratory Demographics

CLIA Number: 49D1107436

Facility Name: BALLAD HEALTH MEDICAL ASSOCIATES FAMILY MEDICINE EXIT 7

Facility Address:
250 STAGECOACH ROAD
BRISTOL, VA
ZIP 24201
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Facility Phone Number: 276 466-0584

Facility Type: Physician Office

Certificate Type: Waiver

CLIA Record

Field Name	Field Value
CLIA Number	49D1107436
LAB Type	Physician Office
Facility Name	BALLAD HEALTH MEDICAL ASSOCIATES FAMILY MEDICINE EXIT 7
Street	250 STAGECOACH ROAD
City	BRISTOL
State	VA
ZIP	24201
Phone	276 466-0584
CertificateType	4
CertificateEffectiveDate	1/24/2024
CertificateExpirationDate	1/23/2026
FacilityType	Waiver

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