49D1040164 CLIA NUMBER - ROXANNE DIETZLER, PC

Laboratory Demographics

  • CLIA Code: 49D1040164
  • Facility Name: ROXANNE DIETZLER, PC
  • Facility Address: 732 THIMBLE SHOALS BOULEVARD
    NEWPORT NEWS, VA
    ZIP 23606
  • Facility Phone: 757 599-3623
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROXANNE DIETZLER
  • NPI Number: 1407928872
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D1040164
LAB Type Physician Office
Facility Name ROXANNE DIETZLER, PC
Street 732 THIMBLE SHOALS BOULEVARD
City NEWPORT NEWS
State VA
ZIP 23606
Phone 757 599-3623
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/2/2025
Certificate Expiration Date 5/1/2027
Facility Type Physician Office
Lab Director ROXANNE DIETZLER

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