49D2083796 CLIA NUMBER - BON SECOURS SUFFOLK PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 49D2083796
  • Facility Name: BON SECOURS SUFFOLK PRIMARY CARE
  • Facility Address: 148 BURNETTS WAY - SUITE 107
    SUFFOLK, VA
    ZIP 23434
  • Facility Phone: 757 738-1375
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HESED N. MUGAISI
  • NPI Number: 1922418235
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D2083796
LAB Type Physician Office
Facility Name BON SECOURS SUFFOLK PRIMARY CARE
Street 148 BURNETTS WAY - SUITE 107
City SUFFOLK
State VA
ZIP 23434
Phone 757 738-1375
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2024
Certificate Expiration Date 9/11/2026
Facility Type Physician Office
Lab Director HESED N. MUGAISI

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