49D0669277 CLIA NUMBER - ROANOKE SURGERY CENTER, LP DBA BLUE RIDGE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 49D0669277
  • Facility Name: ROANOKE SURGERY CENTER, LP DBA BLUE RIDGE SURGERY CENTER
  • Facility Address: 1802 BRAEBURN DRIVE
    SALEM, VA
    ZIP 24153
  • Facility Phone: 540 772-3601
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. GAJAN MAHENDIRAN
  • NPI Number: 1205869211
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D0669277
LAB Type Ambulatory Surgery Center
Facility Name ROANOKE SURGERY CENTER, LP DBA BLUE RIDGE SURGERY CENTER
Street 1802 BRAEBURN DRIVE
City SALEM
State VA
ZIP 24153
Phone 540 772-3601
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 Ambulatory Surgery Center
Lab Director DR. GAJAN MAHENDIRAN

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