49D0227038 CLIA NUMBER - PRIMARY HEALTH GROUP

Laboratory Demographics

  • CLIA Code: 49D0227038
  • Facility Name: PRIMARY HEALTH GROUP
  • Facility Address: 1471 JOHNSTON WILLIS DRIVE
    RICHMOND, VA
    ZIP 23235
  • Facility Phone: 804 320-1333
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEROME DANIEL MD
  • NPI Number: 1578504452
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D0227038
LAB Type Physician Office
Facility Name PRIMARY HEALTH GROUP
Street 1471 JOHNSTON WILLIS DRIVE
City RICHMOND
State VA
ZIP 23235
Phone 804 320-1333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2024
Certificate Expiration Date 7/30/2026
Facility Type Physician Office
Lab Director JEROME DANIEL MD

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