49D2080000 CLIA NUMBER - RENAISSANCE MEDICAL CENTER/CEDAR RECOVERY-BRISTOL

Laboratory Demographics

  • CLIA Code: 49D2080000
  • Facility Name: RENAISSANCE MEDICAL CENTER/CEDAR RECOVERY-BRISTOL
  • Facility Address: 170 BLEVINS BLVD
    BRISTOL, VA
    ZIP 24202
  • Facility Phone: 276 285-3911
  • Facility Type: Other - OFFICE BASED OPIOD TREAT.
  • Facility Type: Waiver
  • Lab Director: STERLING O. FOOSHEE
  • NPI Number: 1568977940
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 49D2080000
LAB Type Other - OFFICE BASED OPIOD TREAT.
Facility Name RENAISSANCE MEDICAL CENTER/CEDAR RECOVERY-BRISTOL
Street 170 BLEVINS BLVD
City BRISTOL
State VA
ZIP 24202
Phone 276 285-3911
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/27/2024
Certificate Expiration Date 6/26/2026
Facility Type Other - OFFICE BASED OPIOD TREAT.
Lab Director STERLING O. FOOSHEE

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