49D2221604 CLIA NUMBER - CLINCH VALLEY PHARMACY

Laboratory Demographics

  • CLIA Code: 49D2221604
  • Facility Name: CLINCH VALLEY PHARMACY
  • Facility Address: 160 MARTINGALE DRIVE
    TAZEWELL, VA
    ZIP 24651
  • Facility Phone: 276 988-4871
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICHARD L. STANSBURY
  • NPI Number: 1730242298
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2221604
LAB Type Pharmacy
Facility Name CLINCH VALLEY PHARMACY
Street 160 MARTINGALE DRIVE
City TAZEWELL
State VA
ZIP 24651
Phone 276 988-4871
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2025
Certificate Expiration Date 4/21/2027
Facility Type Pharmacy
Lab Director RICHARD L. STANSBURY

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