49D2040734 CLIA NUMBER - MINORITY AIDS SUPPORT SERVICES, INC

Laboratory Demographics

  • CLIA Code: 49D2040734
  • Facility Name: MINORITY AIDS SUPPORT SERVICES, INC
  • Facility Address: 247 28TH STREET, SUITE 100
    NEWPORT NEWS, VA
    ZIP 23607
  • Facility Phone: 757 247-1879
  • Facility Type: Other - AIDS SERVICE ORGANIZATION
  • Facility Type: Waiver
  • Lab Director: GWENDOLYN R. ELLIS WILSON
  • NPI Number: 1619660883
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 49D2040734
LAB Type Other - AIDS SERVICE ORGANIZATION
Facility Name MINORITY AIDS SUPPORT SERVICES, INC
Street 247 28TH STREET, SUITE 100
City NEWPORT NEWS
State VA
ZIP 23607
Phone 757 247-1879
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2024
Certificate Expiration Date 5/8/2026
Facility Type Other - AIDS SERVICE ORGANIZATION
Lab Director GWENDOLYN R. ELLIS WILSON

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