49D2173360 CLIA NUMBER - CARILION CRYSTAL SPRING MOB POCT

Laboratory Demographics

  • CLIA Code: 49D2173360
  • Facility Name: CARILION CRYSTAL SPRING MOB POCT
  • Facility Address: 2001 CRYSTAL SPRING AVE, SUITE #140
    ROANOKE, VA
    ZIP 24014
  • Facility Phone: 540 853-0625
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: PAMELA C. FERGUSON
  • NPI Number: 1265808166
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2173360
LAB Type Ancillary Testing Site in Health Care Center
Facility Name CARILION CRYSTAL SPRING MOB POCT
Street 2001 CRYSTAL SPRING AVE, SUITE #140
City ROANOKE
State VA
ZIP 24014
Phone 540 853-0625
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2025
Certificate Expiration Date 10/9/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director PAMELA C. FERGUSON

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