49D2297036 CLIA NUMBER - TEAM MENTATION PLLC

Laboratory Demographics

  • CLIA Code: 49D2297036
  • Facility Name: TEAM MENTATION PLLC
  • Facility Address: 11708 NICKELSVILLE HWY, SUITE 200
    NICKELSVILLE, VA
    ZIP 24271
  • Facility Phone: (276) 248-1880
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DERICK S. REEDY
  • NPI Number: 1942911417
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 49D2297036
LAB Type Physician Office
Facility Name TEAM MENTATION PLLC
Street 11708 NICKELSVILLE HWY, SUITE 200
City NICKELSVILLE
State VA
ZIP 24271
Phone 2762481880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2026
Certificate Expiration Date 1/9/2028
Facility Type Physician Office
Lab Director DERICK S. REEDY

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This page was last updated on: 5/15/2026