49D1089702 CLIA NUMBER - PEDIATRIC DIAGNOSTIC CENTER

Laboratory Demographics

  • CLIA Code: 49D1089702
  • Facility Name: PEDIATRIC DIAGNOSTIC CENTER
  • Facility Address: 2021 CONCERT DRIVE - SUITE 202
    VIRGINIA BEACH, VA
    ZIP 23456
  • Facility Phone: 757 453-6711
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BERNADETTE E. LEIDEL
  • NPI Number: 1245386341
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 49D1089702
LAB Type Physician Office
Facility Name PEDIATRIC DIAGNOSTIC CENTER
Street 2021 CONCERT DRIVE - SUITE 202
City VIRGINIA BEACH
State VA
ZIP 23456
Phone 757 453-6711
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Physician Office
Lab Director BERNADETTE E. LEIDEL

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