49D2233014 CLIA NUMBER - PETERSBURG HOME FOR LADIES

Laboratory Demographics

  • CLIA Code: 49D2233014
  • Facility Name: PETERSBURG HOME FOR LADIES
  • Facility Address: 311 SOUTH JEFFERSON ST
    PETERSBURG, VA
    ZIP 23803
  • Facility Phone: 804 733-0148
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: STACY D. RILEY
  • NPI Number: 1942360201
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 49D2233014
LAB Type Assisted Living Facility
Facility Name PETERSBURG HOME FOR LADIES
Street 311 SOUTH JEFFERSON ST
City PETERSBURG
State VA
ZIP 23803
Phone 804 733-0148
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2025
Certificate Expiration Date 8/18/2027
Facility Type Assisted Living Facility
Lab Director STACY D. RILEY

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