49D0947821 CLIA NUMBER - 400 SOUTH INDEPENDENCE AVENUE OPCO LLC

Laboratory Demographics

  • CLIA Code: 49D0947821
  • Facility Name: 400 SOUTH INDEPENDENCE AVENUE OPCO LLC
  • Facility Address: 400 SOUTH INDEPENDENCE AVENUE
    INDEPENDENCE, VA
    ZIP 24348
  • Facility Phone: 276 773-0303
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ROBERT B. SWORD
  • NPI Number: 1750305033
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 49D0947821
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name 400 SOUTH INDEPENDENCE AVENUE OPCO LLC
Street 400 SOUTH INDEPENDENCE AVENUE
City INDEPENDENCE
State VA
ZIP 24348
Phone 276 773-0303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ROBERT B. SWORD

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