49D2053390 CLIA NUMBER - PARK AVENUE MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 49D2053390
  • Facility Name: PARK AVENUE MEDICAL ASSOCIATES
  • Facility Address: 1761 PARK AVENUE, SW
    NORTON, VA
    ZIP 24273
  • Facility Phone: 276 325-0417
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KARTHIK RAMAKRISHNAN
  • NPI Number: 1336432962
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D2053390
LAB Type Physician Office
Facility Name PARK AVENUE MEDICAL ASSOCIATES
Street 1761 PARK AVENUE, SW
City NORTON
State VA
ZIP 24273
Phone 276 325-0417
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/30/2025
Certificate Expiration Date 1/29/2027
Facility Type Physician Office
Lab Director KARTHIK RAMAKRISHNAN

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