49D2193769 CLIA NUMBER - SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS MEDICAL MOBILE UNIT

Laboratory Demographics

  • CLIA Code: 49D2193769
  • Facility Name: SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS MEDICAL MOBILE UNIT
  • Facility Address: 13191 GLENBROOK AVE
    MEADOWVIEW, VA
    ZIP 24361
  • Facility Phone: 276 496-4492
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: KRISTIN BRESOWAR
  • NPI Number: 1831398718
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D2193769
LAB Type Federally Qualified Health Center
Facility Name SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS MEDICAL MOBILE UNIT
Street 13191 GLENBROOK AVE
City MEADOWVIEW
State VA
ZIP 24361
Phone 276 496-4492
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Federally Qualified Health Center
Lab Director KRISTIN BRESOWAR

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