49D0228987 CLIA NUMBER - RIVERSIDE CANCER SPECIALISTS OF TIDEWATER AND INFUSION CENTER

Laboratory Demographics

  • CLIA Code: 49D0228987
  • Facility Name: RIVERSIDE CANCER SPECIALISTS OF TIDEWATER AND INFUSION CENTER
  • Facility Address: 110 WIMBLEDON SQUARE - SUITE E-1
    CHESAPEAKE, VA
    ZIP 23320
  • Facility Phone: 757 460-1453
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: CHEVONNE LOGAN
  • NPI Number: 1851797922
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 49D0228987
LAB Type Physician Office
Facility Name RIVERSIDE CANCER SPECIALISTS OF TIDEWATER AND INFUSION CENTER
Street 110 WIMBLEDON SQUARE - SUITE E-1
City CHESAPEAKE
State VA
ZIP 23320
Phone 757 460-1453
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director CHEVONNE LOGAN

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