49D2015652 CLIA NUMBER - KIDMED SOUTHSIDE

Laboratory Demographics

  • CLIA Code: 49D2015652
  • Facility Name: KIDMED SOUTHSIDE
  • Facility Address: 5021 CRAIG RATH BOULEVARD BUILDING - IV
    MIDLOTHIAN, VA
    ZIP 23112
  • Facility Phone: 804 592-5437
  • Facility Type: Other - URGENT CARE CENTER
  • Facility Type: Certificate of Compliance
  • Lab Director: JEFFREY BENNETT
  • NPI Number: 1477869337
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D2015652
LAB Type Other - URGENT CARE CENTER
Facility Name KIDMED SOUTHSIDE
Street 5021 CRAIG RATH BOULEVARD BUILDING - IV
City MIDLOTHIAN
State VA
ZIP 23112
Phone 804 592-5437
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type Other - URGENT CARE CENTER
Lab Director JEFFREY BENNETT

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