49D0679652 CLIA NUMBER - PRIMARY HEALTH GROUP PC

Laboratory Demographics

  • CLIA Code: 49D0679652
  • Facility Name: PRIMARY HEALTH GROUP PC
  • Facility Address: 12254 BRANDERS CREEK DRIVE
    CHESTER, VA
    ZIP 23831
  • Facility Phone: 804 271-8990
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: SARA BREEDEN
  • NPI Number: 1154362069
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D0679652
LAB Type Practitioner Other
Facility Name PRIMARY HEALTH GROUP PC
Street 12254 BRANDERS CREEK DRIVE
City CHESTER
State VA
ZIP 23831
Phone 804 271-8990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Practitioner Other
Lab Director SARA BREEDEN

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