49D2306950 CLIA NUMBER - RIVERSIDE INTERNAL MEDICINE BRENTWOOD

Laboratory Demographics

  • CLIA Code: 49D2306950
  • Facility Name: RIVERSIDE INTERNAL MEDICINE BRENTWOOD
  • Facility Address: 10510 JEFFERSON AVE, SUITE G
    NEWPORT NEWS, VA
    ZIP 23601
  • Facility Phone: 757 594-3322
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIRSTEN WATKINS
  • NPI Number: 1053339614
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D2306950
LAB Type Physician Office
Facility Name RIVERSIDE INTERNAL MEDICINE BRENTWOOD
Street 10510 JEFFERSON AVE, SUITE G
City NEWPORT NEWS
State VA
ZIP 23601
Phone 757 594-3322
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/27/2024
Certificate Expiration Date 6/26/2026
Facility Type Physician Office
Lab Director KIRSTEN WATKINS

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