49D2296022 CLIA NUMBER - KENT MEDICAL

Laboratory Demographics

  • CLIA Code: 49D2296022
  • Facility Name: KENT MEDICAL
  • Facility Address: 912 WEST MAIN ST
    LEBANON, VA
    ZIP 24266
  • Facility Phone: 276 880-0211
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILEY R. KENT
  • NPI Number: 1043089147
  • Taxonomy: 363AM0700X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 49D2296022
LAB Type Physician Office
Facility Name KENT MEDICAL
Street 912 WEST MAIN ST
City LEBANON
State VA
ZIP 24266
Phone 276 880-0211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Physician Office
Lab Director WILEY R. KENT

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This page was last updated on: 6/4/2025