49D0669759 CLIA NUMBER - BRUTON AVENUE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 49D0669759
  • Facility Name: BRUTON AVENUE FAMILY PRACTICE
  • Facility Address: 12 BRUTON AVENUE
    NEWPORT NEWS, VA
    ZIP 23601
  • Facility Phone: 757 594-4111
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHARLES K. PHILLIPS
  • NPI Number: 1013933977
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 49D0669759
LAB Type Physician Office
Facility Name BRUTON AVENUE FAMILY PRACTICE
Street 12 BRUTON AVENUE
City NEWPORT NEWS
State VA
ZIP 23601
Phone 757 594-4111
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 5/28/2024
Certificate Expiration Date 5/27/2026
Facility Type Physician Office
Lab Director CHARLES K. PHILLIPS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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