49D1037442 CLIA NUMBER - NORTHERN NECK - MIDDLESEX FREE HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 49D1037442
  • Facility Name: NORTHERN NECK - MIDDLESEX FREE HEALTH CLINIC
  • Facility Address: 51 WILLIAM B GRAHAM COURT
    KILMARNOCK, VA
    ZIP 22482
  • Facility Phone: 804 435-0575
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: CHARLES MARESH
  • NPI Number: 1275586240
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 49D1037442
LAB Type Community Clinic
Facility Name NORTHERN NECK - MIDDLESEX FREE HEALTH CLINIC
Street 51 WILLIAM B GRAHAM COURT
City KILMARNOCK
State VA
ZIP 22482
Phone 804 435-0575
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 2/24/2025
Certificate Expiration Date 2/23/2027
Facility Type Community Clinic
Lab Director CHARLES MARESH

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