49D0932195 CLIA NUMBER - 4355 PHEASANT RIDGE ROAD OPCO LLC

Laboratory Demographics

  • CLIA Code: 49D0932195
  • Facility Name: 4355 PHEASANT RIDGE ROAD OPCO LLC
  • Facility Address: 4355 PHEASANT RIDGE ROAD
    ROANOKE, VA
    ZIP 24014
  • Facility Phone: (540) 725-8210
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KAREN L. BRANDT
  • NPI Number: 1629886577
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 49D0932195
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name 4355 PHEASANT RIDGE ROAD OPCO LLC
Street 4355 PHEASANT RIDGE ROAD
City ROANOKE
State VA
ZIP 24014
Phone 5407258210
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director KAREN L. BRANDT

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This page was last updated on: 6/29/2026