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49D2155321 CLIA NUMBER - CITY OF ROANOKE EMPLOYEE HEALTH CLINIC

Laboratory Demographics

CLIA Number: 49D2155321

Facility Name: CITY OF ROANOKE EMPLOYEE HEALTH CLINIC

Facility Address:
107 CHURCH AVE SW
ROANOKE, VA
ZIP 24011
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Facility Phone Number: 802 857-0400

Facility Type: Other - ONSITE HEALTH CTR

Certificate Type: Waiver
NPI Number: 1265523211

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name Field Value
CLIA Number 49D2155321
LAB Type Other - ONSITE HEALTH CTR
Facility Name CITY OF ROANOKE EMPLOYEE HEALTH CLINIC
Street 107 CHURCH AVE SW
City ROANOKE
State VA
ZIP 24011
Phone 802 857-0400
CertificateType 4
CertificateEffectiveDate 9/27/2022
CertificateExpirationDate 9/26/2024
FacilityType Waiver

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