49D1051766 CLIA NUMBER - CHANCELLOR PEDIATRICS, PC

Laboratory Demographics

  • CLIA Code: 49D1051766
  • Facility Name: CHANCELLOR PEDIATRICS, PC
  • Facility Address: 12004 KILARNEY DRIVE
    FREDERICKSBURG, VA
    ZIP 22407
  • Facility Phone: 540 548-4510
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARLES V. AMORY
  • NPI Number: 1649215948
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 49D1051766
LAB Type Physician Office
Facility Name CHANCELLOR PEDIATRICS, PC
Street 12004 KILARNEY DRIVE
City FREDERICKSBURG
State VA
ZIP 22407
Phone 540 548-4510
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2024
Certificate Expiration Date 3/8/2026
Facility Type Physician Office
Lab Director CHARLES V. AMORY

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This page was last updated on: 6/4/2025