49D2214324 CLIA NUMBER - BRISTOL LIFESTYLE RECOVERY

Laboratory Demographics

  • CLIA Code: 49D2214324
  • Facility Name: BRISTOL LIFESTYLE RECOVERY
  • Facility Address: 261 NORTH STREET
    BRISTOL, VA
    ZIP 24201
  • Facility Phone: 276 821-8030
  • Facility Type: Other - DRUG REHAB FACILITY
  • Facility Type: Waiver
  • Lab Director: DILLON R. FERGUSON
  • NPI Number: 1710952460
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 49D2214324
LAB Type Other - DRUG REHAB FACILITY
Facility Name BRISTOL LIFESTYLE RECOVERY
Street 261 NORTH STREET
City BRISTOL
State VA
ZIP 24201
Phone 276 821-8030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2025
Certificate Expiration Date 2/21/2027
Facility Type Other - DRUG REHAB FACILITY
Lab Director DILLON R. FERGUSON

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