49D2042605 CLIA NUMBER - CHIPPENHAM AMBULATORY SURGERY CENTER, LLC DBA BOULDERS AMBULATORY SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 49D2042605
  • Facility Name: CHIPPENHAM AMBULATORY SURGERY CENTER, LLC DBA BOULDERS AMBULATORY SURGERY CENTER
  • Facility Address: 1115 BOULDERS PARKWAY - SUITE 210
    RICHMOND, VA
    ZIP 23225
  • Facility Phone: 804 672-4040
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: NICOLE HUFFMAN
  • NPI Number: 1093088999
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D2042605
LAB Type Ambulatory Surgery Center
Facility Name CHIPPENHAM AMBULATORY SURGERY CENTER, LLC DBA BOULDERS AMBULATORY SURGERY CENTER
Street 1115 BOULDERS PARKWAY - SUITE 210
City RICHMOND
State VA
ZIP 23225
Phone 804 672-4040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Ambulatory Surgery Center
Lab Director NICOLE HUFFMAN

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This page was last updated on: 6/4/2025