49D2268568 CLIA NUMBER - ADVANTAGE PRIMARY CARE, LLC

Laboratory Demographics

  • CLIA Code: 49D2268568
  • Facility Name: ADVANTAGE PRIMARY CARE, LLC
  • Facility Address: 7605 FOREST AVE, SUITE 412
    RICHMOND, VA
    ZIP 23229
  • Facility Phone: 804 381-6252
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAMES E. DETRICK
  • NPI Number: 1245959287
  • Taxonomy: 363A00000X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 49D2268568
LAB Type Physician Office
Facility Name ADVANTAGE PRIMARY CARE, LLC
Street 7605 FOREST AVE, SUITE 412
City RICHMOND
State VA
ZIP 23229
Phone 804 381-6252
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Physician Office
Lab Director JAMES E. DETRICK

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