49D2045209 CLIA NUMBER - DIRECT ACCESS INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 49D2045209
  • Facility Name: DIRECT ACCESS INTERNAL MEDICINE
  • Facility Address: 6609 MAIN STREET
    GLOUCESTER, VA
    ZIP 23061
  • Facility Phone: 804 824-9153
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. RONALD D. HAGGERTY
  • NPI Number: 1639476831
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D2045209
LAB Type Physician Office
Facility Name DIRECT ACCESS INTERNAL MEDICINE
Street 6609 MAIN STREET
City GLOUCESTER
State VA
ZIP 23061
Phone 804 824-9153
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 10/1/2024
Certificate Expiration Date 9/30/2026
Facility Type Physician Office
Lab Director DR. RONALD D. HAGGERTY

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