49D2214332 CLIA NUMBER - RICHMOND WSP LLC

Laboratory Demographics

CLIA Number: 49D2214332

Facility Name: RICHMOND WSP LLC

Facility Address:
14399 N GAYTON ROAD
GLEN ALLEN, VA
ZIP 23059
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Facility Phone Number: 804 495-8880

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1689885808

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

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
CertificateType	4
CertificateEffectiveDate	2/22/2023
CertificateExpirationDate	2/21/2025
FacilityType	Waiver

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