49D2020874 CLIA NUMBER - SENTARA FAMILY MEDICINE PHYSICIANS - GLOUCESTER

Laboratory Demographics

  • CLIA Code: 49D2020874
  • Facility Name: SENTARA FAMILY MEDICINE PHYSICIANS - GLOUCESTER
  • Facility Address: 5659 PARKWAY DRIVE - SUITE 210
    GLOUCESTER, VA
    ZIP 23061
  • Facility Phone: 804 210-1025
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WAYNE REYNOLDS
  • NPI Number: 1346428976
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D2020874
LAB Type Physician Office
Facility Name SENTARA FAMILY MEDICINE PHYSICIANS - GLOUCESTER
Street 5659 PARKWAY DRIVE - SUITE 210
City GLOUCESTER
State VA
ZIP 23061
Phone 804 210-1025
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Physician Office
Lab Director WAYNE REYNOLDS

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