49D0225083 CLIA NUMBER - RIVERSIDE WHITE STONE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 49D0225083
  • Facility Name: RIVERSIDE WHITE STONE FAMILY PRACTICE
  • Facility Address: 30 SHADY LANE
    WHITE STONE, VA
    ZIP 22578
  • Facility Phone: 804 435-3133
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRIAN K. CUBBAGE
  • NPI Number: 1528211158
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D0225083
LAB Type Physician Office
Facility Name RIVERSIDE WHITE STONE FAMILY PRACTICE
Street 30 SHADY LANE
City WHITE STONE
State VA
ZIP 22578
Phone 804 435-3133
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2024
Certificate Expiration Date 11/30/2026
Facility Type Physician Office
Lab Director BRIAN K. CUBBAGE

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