49D2008908 CLIA NUMBER - RIVERSIDE CANCER SPECIALIST OF TIDEWATER AND INFUSION CENTER

Laboratory Demographics

  • CLIA Code: 49D2008908
  • Facility Name: RIVERSIDE CANCER SPECIALIST OF TIDEWATER AND INFUSION CENTER
  • Facility Address: 5839 HARBOUR VIEW BOULEVARD - SUITE 100A
    SUFFOLK, VA
    ZIP 23435
  • Facility Phone: 757 397-4200
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: CHEVONNE LOGAN
  • NPI Number: 1033515101
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 49D2008908
LAB Type Physician Office
Facility Name RIVERSIDE CANCER SPECIALIST OF TIDEWATER AND INFUSION CENTER
Street 5839 HARBOUR VIEW BOULEVARD - SUITE 100A
City SUFFOLK
State VA
ZIP 23435
Phone 757 397-4200
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 6/22/2025
Certificate Expiration Date 6/21/2027
Facility Type Physician Office
Lab Director CHEVONNE LOGAN

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This page was last updated on: 6/4/2025