49D0233133 CLIA NUMBER - ROMAN EAGLE MEMORIAL HM

Laboratory Demographics

CLIA Number: 49D0233133

Facility Name: ROMAN EAGLE MEMORIAL HM

Facility Address:
2526 N MAIN
DANVILLE, VA
ZIP 24540
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Facility Phone Number: 804 836-9510

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1174695092

Taxonomy: 3336L0003X - Pharmacy
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

CLIA Record

Field Name	Field Value
CLIA Number	49D0233133
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	ROMAN EAGLE MEMORIAL HM
Street	2526 N MAIN
City	DANVILLE
State	VA
ZIP	24540
Phone	804 836-9510
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024