49D2079324 CLIA NUMBER - GLOUCESTER MOBILE CT

Laboratory Demographics

  • CLIA Code: 49D2079324
  • Facility Name: GLOUCESTER MOBILE CT
  • Facility Address: 5659 PARKWAY DRIVE -SUITE 130
    GLOUCESTER, VA
    ZIP 23061
  • Facility Phone: 804 210-1090
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: AUDREY E. STECK
  • NPI Number: 1811915887
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 49D2079324
LAB Type Mobile Laboratory
Facility Name GLOUCESTER MOBILE CT
Street 5659 PARKWAY DRIVE -SUITE 130
City GLOUCESTER
State VA
ZIP 23061
Phone 804 210-1090
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2024
Certificate Expiration Date 6/12/2026
Facility Type Mobile Laboratory
Lab Director AUDREY E. STECK

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