49D0859648 CLIA NUMBER - BRADLEY FREE CLINIC OF ROANOKE VALLEY

Laboratory Demographics

CLIA Number: 49D0859648

Facility Name: BRADLEY FREE CLINIC OF ROANOKE VALLEY

Facility Address:
1240 3RD STREET SW
ROANOKE, VA
ZIP 24016
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Facility Phone Number: 703 344-5156

Facility Type: Other

Certificate Type: Microscopy

NPI Number: 1902157712

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	49D0859648
LAB Type	Other
Facility Name	BRADLEY FREE CLINIC OF ROANOKE VALLEY
Street	1240 3RD STREET SW
City	ROANOKE
State	VA
ZIP	24016
Phone	703 344-5156
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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