49D2313717 CLIA NUMBER - LIFE SUPPORT, LLC

Laboratory Demographics

  • CLIA Code: 49D2313717
  • Facility Name: LIFE SUPPORT, LLC
  • Facility Address: 490 PINEY FOREST ROAD
    DANVILLE, VA
    ZIP 24540
  • Facility Phone: 434 797-1094
  • Facility Type: Other - BEHAVIORAL HEALTH OFFICE
  • Facility Type: Waiver
  • Lab Director: KIIMBERLY H. GIBSON
  • NPI Number: 1295010189
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 49D2313717
LAB Type Other - BEHAVIORAL HEALTH OFFICE
Facility Name LIFE SUPPORT, LLC
Street 490 PINEY FOREST ROAD
City DANVILLE
State VA
ZIP 24540
Phone 434 797-1094
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2024
Certificate Expiration Date 11/5/2026
Facility Type Other - BEHAVIORAL HEALTH OFFICE
Lab Director KIIMBERLY H. GIBSON

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