49D2135629 CLIA NUMBER - GLOUCESTER MATHEWS CARE CLINIC

Laboratory Demographics

  • CLIA Code: 49D2135629
  • Facility Name: GLOUCESTER MATHEWS CARE CLINIC
  • Facility Address: 6031 INDUSTRIAL PARKWAY
    GLOUCESTER, VA
    ZIP 23061
  • Facility Phone: 804 210-1368
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: WAYNE J. REYNOLDS
  • NPI Number: 1184051575
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D2135629
LAB Type Community Clinic
Facility Name GLOUCESTER MATHEWS CARE CLINIC
Street 6031 INDUSTRIAL PARKWAY
City GLOUCESTER
State VA
ZIP 23061
Phone 804 210-1368
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2025
Certificate Expiration Date 8/23/2027
Facility Type Community Clinic
Lab Director WAYNE J. REYNOLDS

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