49D0908968 CLIA NUMBER - RIVERSIDE FISHING BAY FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 49D0908968
  • Facility Name: RIVERSIDE FISHING BAY FAMILY PRACTICE
  • Facility Address: 16681 PULLER HIGHWAY
    DELTAVILLE, VA
    ZIP 23043
  • Facility Phone: 804 776-8000
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: STERLING RANSONE
  • NPI Number: 1053339762
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 49D0908968
LAB Type Physician Office
Facility Name RIVERSIDE FISHING BAY FAMILY PRACTICE
Street 16681 PULLER HIGHWAY
City DELTAVILLE
State VA
ZIP 23043
Phone 804 776-8000
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 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Physician Office
Lab Director STERLING RANSONE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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