49D1059508 CLIA NUMBER - PATRIOT PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 49D1059508
  • Facility Name: PATRIOT PRIMARY CARE
  • Facility Address: 2855 DENBIGH BOULEVARD
    GRAFTON, VA
    ZIP 23692
  • Facility Phone: 757 968-5700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EMILY S. DUDLEY
  • NPI Number: 1962599100
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D1059508
LAB Type Physician Office
Facility Name PATRIOT PRIMARY CARE
Street 2855 DENBIGH BOULEVARD
City GRAFTON
State VA
ZIP 23692
Phone 757 968-5700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Physician Office
Lab Director EMILY S. DUDLEY

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