49D1068171 CLIA NUMBER - PRINCESS ANNE MEDICAL ASSOCIATES

Laboratory Demographics

CLIA Code: 49D1068171
Facility Name: PRINCESS ANNE MEDICAL ASSOCIATES
Facility Address: 1925 GLENN MITCHELL DRIVE - SUITE 100
VIRGINIA BEACH, VA
ZIP 23456
Facility Phone: 757 689-8430
Facility Type: Physician Office
Facility Type: Microscopy
Lab Director: JOEL ANYIWO
NPI Number: 1174725519
Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name	Field Value
CLIA Number	49D1068171
LAB Type	Physician Office
Facility Name	PRINCESS ANNE MEDICAL ASSOCIATES
Street	1925 GLENN MITCHELL DRIVE - SUITE 100
City	VIRGINIA BEACH
State	VA
ZIP	23456
Phone	757 689-8430
Certificate Type	Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description	This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date	2/1/2025
Certificate Expiration Date	1/31/2027
Facility Type	Physician Office
Lab Director	JOEL ANYIWO

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