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49D0226443 CLIA NUMBER - CHICKAHOMINY FAMILY PHYSICIANS-PROVIDENCE FORGE MEDCARE

Laboratory Demographics

CLIA Number: 49D0226443

Facility Name: CHICKAHOMINY FAMILY PHYSICIANS-PROVIDENCE FORGE MEDCARE

Facility Address:
9010 POCAHONTAS TRAIL
PROVIDENCE FORGE, VA
ZIP 23140
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Facility Phone Number: 804 938-4388

Facility Type: Physician Office

Certificate Type: Certificate of Compliance
NPI Number: 1689683724

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 49D0226443
LAB Type Physician Office
Facility Name CHICKAHOMINY FAMILY PHYSICIANS-PROVIDENCE FORGE MEDCARE
Street 9010 POCAHONTAS TRAIL
City PROVIDENCE FORGE
State VA
ZIP 23140
Phone 804 938-4388
CertificateType 2
CertificateEffectiveDate 1/23/2023
CertificateExpirationDate 1/22/2025
FacilityType Compliance

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