49D1102003 CLIA NUMBER - RIVERSIDE WILLAMSBURG GASTROENTEROLOGY SPECIALISTS

Laboratory Demographics

  • CLIA Code: 49D1102003
  • Facility Name: RIVERSIDE WILLAMSBURG GASTROENTEROLOGY SPECIALISTS
  • Facility Address: 120 KINGS WAY SUITES 3200/3300
    WILLIAMSBURG, VA
    ZIP 23185
  • Facility Phone: 757 221-0750
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSEPH O. CONVERSE
  • NPI Number: 1083867311
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D1102003
LAB Type Physician Office
Facility Name RIVERSIDE WILLAMSBURG GASTROENTEROLOGY SPECIALISTS
Street 120 KINGS WAY SUITES 3200/3300
City WILLIAMSBURG
State VA
ZIP 23185
Phone 757 221-0750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2025
Certificate Expiration Date 7/8/2027
Facility Type Physician Office
Lab Director JOSEPH O. CONVERSE

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