49D0230648 CLIA NUMBER - AUTUMN CARE OF PORTSMOUTH

Laboratory Demographics

  • CLIA Code: 49D0230648
  • Facility Name: AUTUMN CARE OF PORTSMOUTH
  • Facility Address: 3610 WINCHESTER DRIVE
    PORTSMOUTH, VA
    ZIP 23707
  • Facility Phone: 804 397-0725
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ROBIN O. LEWIS
  • NPI Number: 1710963459
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 49D0230648
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AUTUMN CARE OF PORTSMOUTH
Street 3610 WINCHESTER DRIVE
City PORTSMOUTH
State VA
ZIP 23707
Phone 804 397-0725
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ROBIN O. LEWIS

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