49D0947211 CLIA NUMBER - TIDEWATER KIDNEY SPECIALISTS INC

Laboratory Demographics

  • CLIA Code: 49D0947211
  • Facility Name: TIDEWATER KIDNEY SPECIALISTS INC
  • Facility Address: 500 W 21ST STREET, SUITE 102
    NORFOLK, VA
    ZIP 23517
  • Facility Phone: 757 623-0005
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: YURY KALMANOVICH
  • NPI Number: 1598282998
  • Taxonomy: 2083P0011X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D0947211
LAB Type Physician Office
Facility Name TIDEWATER KIDNEY SPECIALISTS INC
Street 500 W 21ST STREET, SUITE 102
City NORFOLK
State VA
ZIP 23517
Phone 757 623-0005
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 9/22/2024
Certificate Expiration Date 9/21/2026
Facility Type Physician Office
Lab Director YURY KALMANOVICH

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