49D0966862 CLIA NUMBER - SOUTHSIDE AREA FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 49D0966862
  • Facility Name: SOUTHSIDE AREA FAMILY MEDICINE
  • Facility Address: 324 COMMERCE ROAD - SUITE A
    FARMVILLE, VA
    ZIP 23901
  • Facility Phone: 804 315-2790
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TIMOTHY W. CORBETT SR
  • NPI Number: 1932587243
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D0966862
LAB Type Physician Office
Facility Name SOUTHSIDE AREA FAMILY MEDICINE
Street 324 COMMERCE ROAD - SUITE A
City FARMVILLE
State VA
ZIP 23901
Phone 804 315-2790
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 3/17/2024
Certificate Expiration Date 3/16/2026
Facility Type Physician Office
Lab Director TIMOTHY W. CORBETT SR

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This page was last updated on: 3/20/2025