49D2137492 CLIA NUMBER - SENTARA URGENT CARE - SOUTH BOSTON

Laboratory Demographics

  • CLIA Code: 49D2137492
  • Facility Name: SENTARA URGENT CARE - SOUTH BOSTON
  • Facility Address: 3601 OLD HALIFAX ROAD #100
    SOUTH BOSTON, VA
    ZIP 24592
  • Facility Phone: 434 290-1225
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JON R. GRAY
  • NPI Number: 1972004299
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D2137492
LAB Type Physician Office
Facility Name SENTARA URGENT CARE - SOUTH BOSTON
Street 3601 OLD HALIFAX ROAD #100
City SOUTH BOSTON
State VA
ZIP 24592
Phone 434 290-1225
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2025
Certificate Expiration Date 9/26/2027
Facility Type Physician Office
Lab Director JON R. GRAY

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