49D2260163 CLIA NUMBER - BALANCED OUTPATIENT THERAPY LLC

Laboratory Demographics

  • CLIA Code: 49D2260163
  • Facility Name: BALANCED OUTPATIENT THERAPY LLC
  • Facility Address: 1142 JENSEN DRIVE SUITE 101
    VIRGINIA BEACH, VA
    ZIP 23451
  • Facility Phone: 757 965-9942
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: MATTHEW D. SILVER
  • NPI Number: 1174170161
  • Taxonomy: 225100000X - Physical Therapist

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CLIA Record

Field Name Field Value
CLIA Number 49D2260163
LAB Type Mobile Laboratory
Facility Name BALANCED OUTPATIENT THERAPY LLC
Street 1142 JENSEN DRIVE SUITE 101
City VIRGINIA BEACH
State VA
ZIP 23451
Phone 757 965-9942
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2024
Certificate Expiration Date 5/15/2026
Facility Type Mobile Laboratory
Lab Director MATTHEW D. SILVER

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