49D2050071 CLIA NUMBER - CENTRA PACE - FARMVILLE

Laboratory Demographics

CLIA Code: 49D2050071
Facility Name: CENTRA PACE - FARMVILLE
Facility Address: 1530 SOUTH MAIN STREET
FARMVILLE, VA
ZIP 23901
Facility Phone: 434 315-2890
Facility Type: Physician Office
Facility Type: Waiver
Lab Director: LAURA HOWARD
NPI Number: 1952651770
Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

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CLIA Record

Field Name	Field Value
CLIA Number	49D2050071
LAB Type	Physician Office
Facility Name	CENTRA PACE - FARMVILLE
Street	1530 SOUTH MAIN STREET
City	FARMVILLE
State	VA
ZIP	23901
Phone	434 315-2890
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	11/19/2024
Certificate Expiration Date	11/18/2026
Facility Type	Physician Office
Lab Director	LAURA HOWARD

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