49D2087292 CLIA NUMBER - NORTHERN VIRGINIA CARENOW URGENT CARE LLC DBA WILLOW LAWN

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Laboratory Demographics

CLIA Number: 49D2087292

Facility Name: NORTHERN VIRGINIA CARENOW URGENT CARE LLC DBA WILLOW LAWN

Facility Address:
5215 W BROAD STREET
RICHMOND, VA
ZIP 23230
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Facility Phone Number: 972 906-8171

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1144887324

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	49D2087292
LAB Type	Other - URGENT CARE
Facility Name	NORTHERN VIRGINIA CARENOW URGENT CARE LLC DBA WILLOW LAWN
Street	5215 W BROAD STREET
City	RICHMOND
State	VA
ZIP	23230
Phone	972 906-8171
CertificateType	4
CertificateEffectiveDate	12/1/2022
CertificateExpirationDate	11/30/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024