49D2095600 CLIA NUMBER - LIBERTY MOUNTAIN MEDICAL GROUP

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Laboratory Demographics

CLIA Number: 49D2095600

Facility Name: LIBERTY MOUNTAIN MEDICAL GROUP

Facility Address:
2321 WARDS ROAD
LYNCHBURG, VA
ZIP 24502
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Facility Phone Number: 434 528-2273

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1043602840

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	49D2095600
LAB Type	Physician Office
Facility Name	LIBERTY MOUNTAIN MEDICAL GROUP
Street	2321 WARDS ROAD
City	LYNCHBURG
State	VA
ZIP	24502
Phone	434 528-2273
CertificateType	3
CertificateEffectiveDate	5/9/2023
CertificateExpirationDate	5/8/2025
FacilityType	PPMP

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