49D1065456 CLIA NUMBER - CLINCH VALLEY UROLOGY, LLC CLINCH VALLEY MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 49D1065456
  • Facility Name: CLINCH VALLEY UROLOGY, LLC CLINCH VALLEY MEDICAL CENTER
  • Facility Address: 6719 GOV G C PERRY HWY SUITE 1800
    RICHLANDS, VA
    ZIP 24641
  • Facility Phone: 276 596-6659
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HAO D. PHAM
  • NPI Number: 1114955168
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 49D1065456
LAB Type Physician Office
Facility Name CLINCH VALLEY UROLOGY, LLC CLINCH VALLEY MEDICAL CENTER
Street 6719 GOV G C PERRY HWY SUITE 1800
City RICHLANDS
State VA
ZIP 24641
Phone 276 596-6659
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Physician Office
Lab Director HAO D. PHAM

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