49D2004381 CLIA NUMBER - GLEN ALLEN MEDI LLC DBA MEDI WEIGHT LOSS CLINIC

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Laboratory Demographics

CLIA Number: 49D2004381

Facility Name: GLEN ALLEN MEDI LLC DBA MEDI WEIGHT LOSS CLINIC

Facility Address:
11551 NUCKOLS ROAD - SUITE C
GLEN ALLEN, VA
ZIP 23059
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Facility Phone Number: 804 888-6800

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1083283832

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	49D2004381
LAB Type	Physician Office
Facility Name	GLEN ALLEN MEDI LLC DBA MEDI WEIGHT LOSS CLINIC
Street	11551 NUCKOLS ROAD - SUITE C
City	GLEN ALLEN
State	VA
ZIP	23059
Phone	804 888-6800
CertificateType	4
CertificateEffectiveDate	3/3/2024
CertificateExpirationDate	3/2/2026
FacilityType	Waiver

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