49D2319022 CLIA NUMBER - SHINING STAR PSYCHIATRIC CARE LLC

Laboratory Demographics

  • CLIA Code: 49D2319022
  • Facility Name: SHINING STAR PSYCHIATRIC CARE LLC
  • Facility Address: 2807 N PARHAM RD, STE 311
    RICHMOND, VA
    ZIP 23294
  • Facility Phone: 804 470-9371
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MELITA WILSON-PRIMUS
  • NPI Number: 1053149211
  • Taxonomy: 363LP0808X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 49D2319022
LAB Type Physician Office
Facility Name SHINING STAR PSYCHIATRIC CARE LLC
Street 2807 N PARHAM RD, STE 311
City RICHMOND
State VA
ZIP 23294
Phone 804 470-9371
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2025
Certificate Expiration Date 2/20/2027
Facility Type Physician Office
Lab Director MELITA WILSON-PRIMUS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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