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General NPI Number Information
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NPI Number | 1083992523
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Entity Type | Organization
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Legal Business Name | CENTRAL VIRGINIA FAMILY PHYSICIANS, INC. LABORATORY
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Dates
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Enumeration Date | 08/02/2011
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Last Update Date | 01/14/2015
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Provider Practice Location Address
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Address Line | 2019 TATE SPRINGS RD LOWER LEVEL
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City | LYNCHBURG
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State | VA
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Zip | 24501-1111
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Country | US
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Telephone | 434-846-7708
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Fax | 434-846-7713
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Provider Business Mailing Address
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Address Line | 1111 CORPORATE PARK DR STE C
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City | FOREST
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State | VA
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Zip | 24551-2286
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Country | US
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Telephone | 434-846-7708
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Fax | 434-846-7713
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | MRS. KAREN L HAYNES
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Credential |
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Telephone | 434-382-1139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 49D0914434
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License Number State | VA
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