49D2093143 CLIA NUMBER - KIDMED - STAFFORD

Laboratory Demographics

  • CLIA Code: 49D2093143
  • Facility Name: KIDMED - STAFFORD
  • Facility Address: 20 DOC STONE ROAD
    STAFFORD, VA
    ZIP 22556
  • Facility Phone: 540 602-7766
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JEFFREY E. BENNETT
  • NPI Number: 1174042022
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D2093143
LAB Type Physician Office
Facility Name KIDMED - STAFFORD
Street 20 DOC STONE ROAD
City STAFFORD
State VA
ZIP 22556
Phone 540 602-7766
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/4/2023
Certificate Expiration Date 8/3/2025
Facility Type Physician Office
Lab Director JEFFREY E. BENNETT

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This page was last updated on: 3/20/2025