49D1015712 CLIA NUMBER - ROANOKE AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 49D1015712
  • Facility Name: ROANOKE AMBULATORY SURGERY CENTER
  • Facility Address: 1102 JEFFERSON STREET, SE
    ROANOKE, VA
    ZIP 24016
  • Facility Phone: (540) 342-0707
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BECKY J. CALDWELL
  • NPI Number: 1013914985
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D1015712
LAB Type Ambulatory Surgery Center
Facility Name ROANOKE AMBULATORY SURGERY CENTER
Street 1102 JEFFERSON STREET, SE
City ROANOKE
State VA
ZIP 24016
Phone 5403420707
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type Ambulatory Surgery Center
Lab Director BECKY J. CALDWELL

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This page was last updated on: 5/15/2026