49D1098151 CLIA NUMBER - VIRGINIA BRAIN AND SPINE CENTER, INC

Laboratory Demographics

CLIA Number: 49D1098151

Facility Name: VIRGINIA BRAIN AND SPINE CENTER, INC

Facility Address:
1818 AMHERST STREET
WINCHESTER, VA
ZIP 22601
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Facility Phone Number: 540 450-2339

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1356720437

Taxonomy: 207QA0401X - Family Medicine
A family medicine physician who specializes in the diagnosis and treatment of addictions.

CLIA Record

Field Name	Field Value
CLIA Number	49D1098151
LAB Type	Physician Office
Facility Name	VIRGINIA BRAIN AND SPINE CENTER, INC
Street	1818 AMHERST STREET
City	WINCHESTER
State	VA
ZIP	22601
Phone	540 450-2339
CertificateType	4
CertificateEffectiveDate	4/13/2023
CertificateExpirationDate	4/12/2025
FacilityType	Waiver

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