49D1019243 CLIA NUMBER - CHILDREN AND ADOLESCENTS CLINIC

Laboratory Demographics

  • CLIA Code: 49D1019243
  • Facility Name: CHILDREN AND ADOLESCENTS CLINIC
  • Facility Address: 648 SOUTHPARK BOULEVARD - SUITE C
    COLONIAL HEIGHTS, VA
    ZIP 23834
  • Facility Phone: 804 526-1020
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARUWAN SIRI

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CLIA Record

Field Name Field Value
CLIA Number 49D1019243
LAB Type Physician Office
Facility Name CHILDREN AND ADOLESCENTS CLINIC
Street 648 SOUTHPARK BOULEVARD - SUITE C
City COLONIAL HEIGHTS
State VA
ZIP 23834
Phone 804 526-1020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/13/2023
Certificate Expiration Date 11/12/2025
Facility Type Physician Office
Lab Director CHARUWAN SIRI

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This page was last updated on: 6/4/2025