| NAME |
VIRGINIA BEACH VA CLINIC |
| STATE |
VIRGINIA |
| STREET ADDR. 1 |
244 CLEARFIELD AVE, #401 |
| CITY |
VIRGINIA BEACH |
| ZIP |
23462-1816 |
| OFFICIAL VA NAME |
VIRGINIA BEACH VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
VIRGINIA BEACH VA CLINIC |
| ST. ADDR. 1 (MAILING) |
244 CLEARFIELD AVE, #401 |
| CITY (MAILING) |
VIRGINIA BEACH |
| STATE (MAILING) |
VIRGINIA |
| ZIP (MAILING) |
23462-1816 |
| EFFECTIVE DATE/TIME |
-
- 2007-07-30 00:00:00
- STATUS: ACTIVE
- NPI: 1194995241
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
590GB |
| IDENTIFIER |
-
- CODING SYSTEM: CLIA
- ID: 49D1065754
|
