49D2293518 CLIA NUMBER - MEDI-LAB DIAGNOSTIC CENTER LLC

Laboratory Demographics

  • CLIA Code: 49D2293518
  • Facility Name: MEDI-LAB DIAGNOSTIC CENTER LLC
  • Facility Address: 77 SOUTH MAIN ST
    KILMARNOCK, VA
    ZIP 22482
  • Facility Phone: 804 896-6177
  • Facility Type: Public Health Laboratories
  • Facility Type: Waiver
  • Lab Director: LAKIA GAINES
  • NPI Number: 1780303594
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 49D2293518
LAB Type Public Health Laboratories
Facility Name MEDI-LAB DIAGNOSTIC CENTER LLC
Street 77 SOUTH MAIN ST
City KILMARNOCK
State VA
ZIP 22482
Phone 804 896-6177
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2023
Certificate Expiration Date 11/8/2025
Facility Type Public Health Laboratories
Lab Director LAKIA GAINES

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