49D2149173 CLIA NUMBER - CARILION CLINIC UROLOGY - WYTHEVILLE

Laboratory Demographics

  • CLIA Code: 49D2149173
  • Facility Name: CARILION CLINIC UROLOGY - WYTHEVILLE
  • Facility Address: 1150 HOLSTON RD
    WYTHEVILLE, VA
    ZIP 24382
  • Facility Phone: 540 382-7321
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHRISTOPHER R. REYNOLDS
  • NPI Number: 1568087476
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D2149173
LAB Type Physician Office
Facility Name CARILION CLINIC UROLOGY - WYTHEVILLE
Street 1150 HOLSTON RD
City WYTHEVILLE
State VA
ZIP 24382
Phone 540 382-7321
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 5/25/2024
Certificate Expiration Date 5/24/2026
Facility Type Physician Office
Lab Director CHRISTOPHER R. REYNOLDS

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This page was last updated on: 6/4/2025