49D0970528 CLIA NUMBER - COASTAL FAMILY PRACTICE PC

Laboratory Demographics

  • CLIA Code: 49D0970528
  • Facility Name: COASTAL FAMILY PRACTICE PC
  • Facility Address: 2109 MCCOMAS WAY SUITE 102
    VIRGINIA BEACH, VA
    ZIP 23456
  • Facility Phone: 757 563-2800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MITCHELL B. MILLER MD
  • NPI Number: 1295893097
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D0970528
LAB Type Physician Office
Facility Name COASTAL FAMILY PRACTICE PC
Street 2109 MCCOMAS WAY SUITE 102
City VIRGINIA BEACH
State VA
ZIP 23456
Phone 757 563-2800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/16/2024
Certificate Expiration Date 2/15/2026
Facility Type Physician Office
Lab Director MITCHELL B. MILLER MD

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