49D1000637 CLIA NUMBER - SENTARA FAMILY MEDICINE PHYSICIANS PORT WARWICK 1

Laboratory Demographics

  • CLIA Code: 49D1000637
  • Facility Name: SENTARA FAMILY MEDICINE PHYSICIANS PORT WARWICK 1
  • Facility Address: 11803 JEFFERSON AVENUE - SUITE 100
    NEWPORT NEWS, VA
    ZIP 23606
  • Facility Phone: 757 594-1850
  • Facility Type: Ambulance
  • Facility Type: Microscopy
  • Lab Director: ROLAND BERCASIO, MD
  • NPI Number: 1578778031
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D1000637
LAB Type Ambulance
Facility Name SENTARA FAMILY MEDICINE PHYSICIANS PORT WARWICK 1
Street 11803 JEFFERSON AVENUE - SUITE 100
City NEWPORT NEWS
State VA
ZIP 23606
Phone 757 594-1850
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 6/19/2024
Certificate Expiration Date 6/18/2026
Facility Type Ambulance
Lab Director ROLAND BERCASIO, MD

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