49D2214332 CLIA NUMBER - RICHMOND WSP LLC

Laboratory Demographics

  • CLIA Code: 49D2214332
  • Facility Name: RICHMOND WSP LLC
  • Facility Address: 14399 N GAYTON ROAD
    GLEN ALLEN, VA
    ZIP 23059
  • Facility Phone: 804 495-8880
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: MANDI STATTELMAN
  • NPI Number: 1689885808
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 49D2214332
LAB Type Assisted Living Facility
Facility Name RICHMOND WSP LLC
Street 14399 N GAYTON ROAD
City GLEN ALLEN
State VA
ZIP 23059
Phone 804 495-8880
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 Assisted Living Facility
Lab Director MANDI STATTELMAN

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