49D0678490 CLIA NUMBER - RAPPAHANNOCK AREA HEALTH DISTRICT

Laboratory Demographics

CLIA Code: 49D0678490
Facility Name: RAPPAHANNOCK AREA HEALTH DISTRICT
Facility Address: 608 JACKSON STREET
FREDERICKSBURG, VA
ZIP 22401
Facility Phone: 540 899-4797
Facility Type: Community Clinic
Facility Type: Microscopy
Lab Director: OLUGBENGA O. OBASANJO
NPI Number: 1144600776
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	49D0678490
LAB Type	Community Clinic
Facility Name	RAPPAHANNOCK AREA HEALTH DISTRICT
Street	608 JACKSON STREET
City	FREDERICKSBURG
State	VA
ZIP	22401
Phone	540 899-4797
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	4/12/2024
Certificate Expiration Date	4/11/2026
Facility Type	Community Clinic
Lab Director	OLUGBENGA O. OBASANJO

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