49D0715040 CLIA NUMBER - LUCY CORR VILLAGE

Laboratory Demographics

  • CLIA Code: 49D0715040
  • Facility Name: LUCY CORR VILLAGE
  • Facility Address: 6800 LUCY CORR BOULEVARD
    CHESTERFIELD, VA
    ZIP 23832
  • Facility Phone: 804 748-1511
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DERRICK K. KENDALL
  • NPI Number: 1992713812
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 49D0715040
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LUCY CORR VILLAGE
Street 6800 LUCY CORR BOULEVARD
City CHESTERFIELD
State VA
ZIP 23832
Phone 804 748-1511
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 Skilled Nursing Facility/Nursing Facility
Lab Director DERRICK K. KENDALL

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This page was last updated on: 6/4/2025