49D1087292 CLIA NUMBER - KIDMED WEST END

Laboratory Demographics

  • CLIA Code: 49D1087292
  • Facility Name: KIDMED WEST END
  • Facility Address: 4687 POUNCEY TRACT ROAD
    GLEN ALLEN, VA
    ZIP 23059
  • Facility Phone: 804 422-5437
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JEFFREY E. BENNETT
  • NPI Number: 1407013121
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D1087292
LAB Type Physician Office
Facility Name KIDMED WEST END
Street 4687 POUNCEY TRACT ROAD
City GLEN ALLEN
State VA
ZIP 23059
Phone 804 422-5437
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/27/2025
Certificate Expiration Date 8/26/2027
Facility Type Physician Office
Lab Director JEFFREY E. BENNETT

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