49D1047615 CLIA NUMBER - LGBT LIFE CENTER

Laboratory Demographics

  • CLIA Code: 49D1047615
  • Facility Name: LGBT LIFE CENTER
  • Facility Address: 5360 ROBIN HOOD ROAD, SUITE 202
    NORFOLK, VA
    ZIP 23513
  • Facility Phone: (757) 640-0929
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: STACIE WALLS
  • NPI Number: 1497047237
  • Taxonomy: 101YM0800X - Counselor

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CLIA Record

Field Name Field Value
CLIA Number 49D1047615
LAB Type Mobile Laboratory
Facility Name LGBT LIFE CENTER
Street 5360 ROBIN HOOD ROAD, SUITE 202
City NORFOLK
State VA
ZIP 23513
Phone 7576400929
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2025
Certificate Expiration Date 11/8/2027
Facility Type Mobile Laboratory
Lab Director STACIE WALLS

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