49D0233092 CLIA NUMBER - CENTRA MEDICAL GROUP BROOKNEAL

Laboratory Demographics

  • CLIA Code: 49D0233092
  • Facility Name: CENTRA MEDICAL GROUP BROOKNEAL
  • Facility Address: 104 CAROLINA AVENUE
    BROOKNEAL, VA
    ZIP 24528
  • Facility Phone: 434 376-2325
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: VINCENT J. WALDRON
  • NPI Number: 1861288656
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D0233092
LAB Type Physician Office
Facility Name CENTRA MEDICAL GROUP BROOKNEAL
Street 104 CAROLINA AVENUE
City BROOKNEAL
State VA
ZIP 24528
Phone 434 376-2325
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director VINCENT J. WALDRON

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