49D1006365 CLIA NUMBER - CHINCOTEAGUE ISLAND COMMUNITY HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 49D1006365
  • Facility Name: CHINCOTEAGUE ISLAND COMMUNITY HEALTH CENTER
  • Facility Address: 4049 MAIN STREET
    CHINCOTEAGUE ISLAND, VA
    ZIP 23336
  • Facility Phone: 757 414-0400
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: LAUREN A. EVONIUK
  • NPI Number: 1871256313
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 49D1006365
LAB Type Federally Qualified Health Center
Facility Name CHINCOTEAGUE ISLAND COMMUNITY HEALTH CENTER
Street 4049 MAIN STREET
City CHINCOTEAGUE ISLAND
State VA
ZIP 23336
Phone 757 414-0400
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 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type Federally Qualified Health Center
Lab Director LAUREN A. EVONIUK

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