49D1038524 CLIA NUMBER - RIVERSIDE SHORE CANCER INSTITUTE

Laboratory Demographics

CLIA Number: 49D1038524

Facility Name: RIVERSIDE SHORE CANCER INSTITUTE

Facility Address:
20480 MARKET STREET
ONANCOCK, VA
ZIP 23417
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Facility Phone Number: 757 302-2600

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1417495367

Taxonomy: 2085R0001X - Radiology
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.

CLIA Record

Field Name	Field Value
CLIA Number	49D1038524
LAB Type	Other
Facility Name	RIVERSIDE SHORE CANCER INSTITUTE
Street	20480 MARKET STREET
City	ONANCOCK
State	VA
ZIP	23417
Phone	757 302-2600
CertificateType	4
CertificateEffectiveDate	3/22/2023
CertificateExpirationDate	3/21/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024