49D0939511 CLIA NUMBER - MOSTA G HAQUE MD

Laboratory Demographics

  • CLIA Code: 49D0939511
  • Facility Name: MOSTA G HAQUE MD
  • Facility Address: 301 GOODE WAY STREET - SUITE 201
    PORTSMOUTH, VA
    ZIP 23704
  • Facility Phone: 757 397-0700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOSTA G. HAGUE
  • NPI Number: 1164465639
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D0939511
LAB Type Physician Office
Facility Name MOSTA G HAQUE MD
Street 301 GOODE WAY STREET - SUITE 201
City PORTSMOUTH
State VA
ZIP 23704
Phone 757 397-0700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2024
Certificate Expiration Date 1/26/2026
Facility Type Physician Office
Lab Director MOSTA G. HAGUE

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