49D2000970 CLIA NUMBER - EAGLE HARBOR MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 49D2000970
  • Facility Name: EAGLE HARBOR MEDICAL ASSOCIATES
  • Facility Address: 13609 CARROLLTON BOULEVARD - SUITE 11
    CARROLLTON, VA
    ZIP 23314
  • Facility Phone: 757 238-8751
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KIMBERLY STONE
  • NPI Number: 1316193741
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D2000970
LAB Type Physician Office
Facility Name EAGLE HARBOR MEDICAL ASSOCIATES
Street 13609 CARROLLTON BOULEVARD - SUITE 11
City CARROLLTON
State VA
ZIP 23314
Phone 757 238-8751
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 12/9/2023
Certificate Expiration Date 12/8/2025
Facility Type Physician Office
Lab Director KIMBERLY STONE

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