49D2072621 CLIA NUMBER - RIVERSIDE HOSPITAL, INC D/B/A GLOUCESTER GASTROENTEROLOGY

Laboratory Demographics

  • CLIA Code: 49D2072621
  • Facility Name: RIVERSIDE HOSPITAL, INC D/B/A GLOUCESTER GASTROENTEROLOGY
  • Facility Address: 7547 MEDICAL DRIVE, SUITE 2300
    GLOUCESTER, VA
    ZIP 23061
  • Facility Phone: 804 693-2720
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSEPH O. CONVERSE
  • NPI Number: 1790863645
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D2072621
LAB Type Physician Office
Facility Name RIVERSIDE HOSPITAL, INC D/B/A GLOUCESTER GASTROENTEROLOGY
Street 7547 MEDICAL DRIVE, SUITE 2300
City GLOUCESTER
State VA
ZIP 23061
Phone 804 693-2720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2024
Certificate Expiration Date 2/2/2026
Facility Type Physician Office
Lab Director JOSEPH O. CONVERSE

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