49D0920855 CLIA NUMBER - RIVERSIDE LIFELONG HEALTH AND REHABILITATION PATRIOTS COLONY

Laboratory Demographics

  • CLIA Code: 49D0920855
  • Facility Name: RIVERSIDE LIFELONG HEALTH AND REHABILITATION PATRIOTS COLONY
  • Facility Address: 6000 PATRIOTS COLONY DRIVE
    WILLIAMSBURG, VA
    ZIP 23188
  • Facility Phone: 757 585-7050
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: EBONIE I. HENDERSON
  • NPI Number: 1205945904
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 49D0920855
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name RIVERSIDE LIFELONG HEALTH AND REHABILITATION PATRIOTS COLONY
Street 6000 PATRIOTS COLONY DRIVE
City WILLIAMSBURG
State VA
ZIP 23188
Phone 757 585-7050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2024
Certificate Expiration Date 10/9/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director EBONIE I. HENDERSON

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