49D1004474 CLIA NUMBER - NEPHROLOGY SPECIALIST, PC

Laboratory Demographics

  • CLIA Code: 49D1004474
  • Facility Name: NEPHROLOGY SPECIALIST, PC
  • Facility Address: 8400 NORTH RUN MEDICAL DRIVE - SUITE 200
    MECHANICSVILLE, VA
    ZIP 23116
  • Facility Phone: 804 288-6750
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GERALD E. KEIGHTLEY III
  • NPI Number: 1578645107
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D1004474
LAB Type Physician Office
Facility Name NEPHROLOGY SPECIALIST, PC
Street 8400 NORTH RUN MEDICAL DRIVE - SUITE 200
City MECHANICSVILLE
State VA
ZIP 23116
Phone 804 288-6750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2024
Certificate Expiration Date 4/30/2026
Facility Type Physician Office
Lab Director GERALD E. KEIGHTLEY III

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