49D2280429 CLIA NUMBER - WYNN MEDICAL CENTER PLLC

Laboratory Demographics

  • CLIA Code: 49D2280429
  • Facility Name: WYNN MEDICAL CENTER PLLC
  • Facility Address: 145 DOLLAR DR
    PENNINGTON GAP, VA
    ZIP 24277
  • Facility Phone: 276 231-9227
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: LISA WYNN
  • NPI Number: 1457056566
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D2280429
LAB Type Practitioner Other
Facility Name WYNN MEDICAL CENTER PLLC
Street 145 DOLLAR DR
City PENNINGTON GAP
State VA
ZIP 24277
Phone 276 231-9227
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/19/2025
Certificate Expiration Date 4/18/2027
Facility Type Practitioner Other
Lab Director LISA WYNN

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