49D0921780 CLIA NUMBER - RAI CHURCHLAND-CHESAPEAKE

Laboratory Demographics

  • CLIA Code: 49D0921780
  • Facility Name: RAI CHURCHLAND-CHESAPEAKE
  • Facility Address: 5846 CHURCHLAND BOULEVARD
    PORTSMOUTH, VA
    ZIP 23703
  • Facility Phone: 757 938-1720
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: KEITH H. ZAITOUN
  • NPI Number: 1215049796
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D0921780
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name RAI CHURCHLAND-CHESAPEAKE
Street 5846 CHURCHLAND BOULEVARD
City PORTSMOUTH
State VA
ZIP 23703
Phone 757 938-1720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director KEITH H. ZAITOUN

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This page was last updated on: 3/20/2025