49D2271017 CLIA NUMBER - ROANOKE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 49D2271017
  • Facility Name: ROANOKE PEDIATRICS
  • Facility Address: 1901 DENNISTON AVE SW
    ROANOKE, VA
    ZIP 24015
  • Facility Phone: 540 613-8565
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATHEW HENDERSON
  • NPI Number: 1760158208
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 49D2271017
LAB Type Physician Office
Facility Name ROANOKE PEDIATRICS
Street 1901 DENNISTON AVE SW
City ROANOKE
State VA
ZIP 24015
Phone 540 613-8565
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Physician Office
Lab Director MATHEW HENDERSON

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