49D1039697 CLIA NUMBER - GUADALUPE FREE CLINIC

Laboratory Demographics

  • CLIA Code: 49D1039697
  • Facility Name: GUADALUPE FREE CLINIC
  • Facility Address: 5 IRVING AVENUE SOUTH
    COLONIAL BEACH, VA
    ZIP 22443
  • Facility Phone: (804) 224-7221
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: DANIEL MULDOON MD
  • NPI Number: 1417778275
  • Taxonomy: 3336C0002X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D1039697
LAB Type Other
Facility Name GUADALUPE FREE CLINIC
Street 5 IRVING AVENUE SOUTH
City COLONIAL BEACH
State VA
ZIP 22443
Phone 8042247221
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Other
Lab Director DANIEL MULDOON MD

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This page was last updated on: 5/18/2026