49D0661105 CLIA NUMBER - 1410 NORTH AGUSTA STREET OPCO LLC

Laboratory Demographics

  • CLIA Code: 49D0661105
  • Facility Name: 1410 NORTH AGUSTA STREET OPCO LLC
  • Facility Address: 1410 NORTH AUGUSTA STREET
    STAUNTON, VA
    ZIP 24401
  • Facility Phone: 540 886-6233
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHAD A. BREACH
  • NPI Number: 1861416414
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 49D0661105
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name 1410 NORTH AGUSTA STREET OPCO LLC
Street 1410 NORTH AUGUSTA STREET
City STAUNTON
State VA
ZIP 24401
Phone 540 886-6233
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 CHAD A. BREACH

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