49D2054099 CLIA NUMBER - PENINSULA KIDNEY ASSOCIATES

Laboratory Demographics

  • CLIA Code: 49D2054099
  • Facility Name: PENINSULA KIDNEY ASSOCIATES
  • Facility Address: 205 BULIFANTS BOULEVARD - SUITE A
    WILLIAMSBURG, VA
    ZIP 23188
  • Facility Phone: 757 251-7469
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SHUPING WANG
  • NPI Number: 1649296286
  • Taxonomy: 2086S0129X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 49D2054099
LAB Type Physician Office
Facility Name PENINSULA KIDNEY ASSOCIATES
Street 205 BULIFANTS BOULEVARD - SUITE A
City WILLIAMSBURG
State VA
ZIP 23188
Phone 757 251-7469
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/13/2025
Certificate Expiration Date 2/12/2027
Facility Type Physician Office
Lab Director SHUPING WANG

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