49D1086569 CLIA NUMBER - HORIZON HEALTH SVS - SURRY MEDICAL CENTER

Laboratory Demographics

CLIA Number: 49D1086569

Facility Name: HORIZON HEALTH SVS - SURRY MEDICAL CENTER

Facility Address:
440 COLONIAL TRAIL WEST
DENDRON, VA
ZIP 23839
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Facility Phone Number: 757 294-3981

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1518137389

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	49D1086569
LAB Type	Federally Qualified Health Center
Facility Name	HORIZON HEALTH SVS - SURRY MEDICAL CENTER
Street	440 COLONIAL TRAIL WEST
City	DENDRON
State	VA
ZIP	23839
Phone	757 294-3981
CertificateType	4
CertificateEffectiveDate	1/3/2023
CertificateExpirationDate	1/2/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024