49D1064479 CLIA NUMBER - HEALTH & PREVENTIVE SERVICES-RICHMOND SENTARA HEALTHCARE/OPTIMA HEALTH

Laboratory Demographics

CLIA Code: 49D1064479
Facility Name: HEALTH & PREVENTIVE SERVICES-RICHMOND SENTARA HEALTHCARE/OPTIMA HEALTH
Facility Address: 10800 NUCKOLS ROAD
GLEN ALLEN, VA
ZIP 23060
Facility Phone: 804 521-7470
Facility Type: Health Fair
Facility Type: Waiver
Lab Director: TERRINA THOMAS
NPI Number: 1841436599
Taxonomy: 322D00000X - Residential Treatment Facility, Emotionally Disturbed Children

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CLIA Record

Field Name	Field Value
CLIA Number	49D1064479
LAB Type	Health Fair
Facility Name	HEALTH & PREVENTIVE SERVICES-RICHMOND SENTARA HEALTHCARE/OPTIMA HEALTH
Street	10800 NUCKOLS ROAD
City	GLEN ALLEN
State	VA
ZIP	23060
Phone	804 521-7470
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	2/7/2025
Certificate Expiration Date	2/6/2027
Facility Type	Health Fair
Lab Director	TERRINA THOMAS

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