49D2011464 CLIA NUMBER - MEDI WEIGHTLOSS CLINICS

Laboratory Demographics

  • CLIA Code: 49D2011464
  • Facility Name: MEDI WEIGHTLOSS CLINICS
  • Facility Address: 11551 NUCKOLS ROAD - SUITE C
    GLEN ALLEN, VA
    ZIP 23058
  • Facility Phone: 804 888-6800
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DANNY W. SHABAN
  • NPI Number: 1407232770
  • Taxonomy: 207QB0002X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D2011464
LAB Type Practitioner Other
Facility Name MEDI WEIGHTLOSS CLINICS
Street 11551 NUCKOLS ROAD - SUITE C
City GLEN ALLEN
State VA
ZIP 23058
Phone 804 888-6800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2024
Certificate Expiration Date 8/16/2026
Facility Type Practitioner Other
Lab Director DANNY W. SHABAN

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