49D2174539 CLIA NUMBER - NEW KENT PEDIATRICS

Laboratory Demographics

  • CLIA Code: 49D2174539
  • Facility Name: NEW KENT PEDIATRICS
  • Facility Address: 7410 COOPER TAVERN ROAD STE B
    QUINTON, VA
    ZIP 23141
  • Facility Phone: 804 223-3608
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JENNY L. BRADY
  • NPI Number: 1811452576
  • Taxonomy: 363LP0200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 49D2174539
LAB Type Practitioner Other
Facility Name NEW KENT PEDIATRICS
Street 7410 COOPER TAVERN ROAD STE B
City QUINTON
State VA
ZIP 23141
Phone 804 223-3608
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2023
Certificate Expiration Date 11/4/2025
Facility Type Practitioner Other
Lab Director JENNY L. BRADY

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