49D0698104 CLIA NUMBER - MOUNTAIN REGION FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 49D0698104

Facility Name: MOUNTAIN REGION FAMILY PRACTICE

Facility Address:
142 MEADE AVE
NICKELSVILLE, VA
ZIP 24271
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Facility Phone Number: 276 479-2201

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1467565804

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	49D0698104
LAB Type	Physician Office
Facility Name	MOUNTAIN REGION FAMILY PRACTICE
Street	142 MEADE AVE
City	NICKELSVILLE
State	VA
ZIP	24271
Phone	276 479-2201
CertificateType	4
CertificateEffectiveDate	8/21/2022
CertificateExpirationDate	8/20/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024