49D2198758 CLIA NUMBER - DICKENSON COUNTY BEHAVIORAL HEALTH SERVICES

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Laboratory Demographics

CLIA Number: 49D2198758

Facility Name: DICKENSON COUNTY BEHAVIORAL HEALTH SERVICES

Facility Address:
440 FOX TOWN ROAD
CLINTWOOD, VA
ZIP 24228
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Facility Phone Number: 276 926-1682

Facility Type: Other - COMMUNITY MENTAL HLTH CTR

Certificate Type: Waiver

NPI Number: 1649209990

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	49D2198758
LAB Type	Other - COMMUNITY MENTAL HLTH CTR
Facility Name	DICKENSON COUNTY BEHAVIORAL HEALTH SERVICES
Street	440 FOX TOWN ROAD
City	CLINTWOOD
State	VA
ZIP	24228
Phone	276 926-1682
CertificateType	4
CertificateEffectiveDate	11/4/2022
CertificateExpirationDate	11/3/2024
FacilityType	Waiver

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