49D2031804 CLIA NUMBER - CARILION CLINIC ADOLESCENT MEDICINE WILLIAM FLEMING HIGH SCHOOL

Laboratory Demographics

  • CLIA Code: 49D2031804
  • Facility Name: CARILION CLINIC ADOLESCENT MEDICINE WILLIAM FLEMING HIGH SCHOOL
  • Facility Address: 3649 FERNCLIFF AVENUE
    ROANOKE, VA
    ZIP 24017
  • Facility Phone: 540 853-1368
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ALLEN R. BLACKWOOD

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CLIA Record

Field Name Field Value
CLIA Number 49D2031804
LAB Type Physician Office
Facility Name CARILION CLINIC ADOLESCENT MEDICINE WILLIAM FLEMING HIGH SCHOOL
Street 3649 FERNCLIFF AVENUE
City ROANOKE
State VA
ZIP 24017
Phone 540 853-1368
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Physician Office
Lab Director ALLEN R. BLACKWOOD

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This page was last updated on: 3/20/2025