49D0228772 CLIA NUMBER - PEMBROKE MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 49D0228772
  • Facility Name: PEMBROKE MEDICAL ASSOCIATES
  • Facility Address: 4445 CORPORATION LANE - SUITE 120
    VIRGINIA BEACH, VA
    ZIP 23462
  • Facility Phone: 757 686-3500
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: VERA G. GOODE
  • NPI Number: 1609056688
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 49D0228772
LAB Type Physician Office
Facility Name PEMBROKE MEDICAL ASSOCIATES
Street 4445 CORPORATION LANE - SUITE 120
City VIRGINIA BEACH
State VA
ZIP 23462
Phone 757 686-3500
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Physician Office
Lab Director VERA G. GOODE

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