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SOUTHERN DOMINION HEALTH SYSTEM
NPI 1104067701
Clinic/Center in Amelia Court House, VA

Active since March 12, 2009CLIA 49D0231234 · Microscopy
8631 NAMOZINE RD, AMELIA COURT HOUSE, VA 23002(804) 561-6263 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southern Dominion Health System NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN DOMINION HEALTH SYSTEM (NPI 1104067701) is a healthcare organization registered as a clinic/center in Amelia Court House, Virginia and active in the NPI registry since March 2009. The organization holds a CLIA Microscopy certificate valid through December 22, 2027 and lists Mary R Turner, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1104067701
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSOUTHERN DOMINION HEALTH SYSTEM
Location Address8631 NAMOZINE RDAmelia Court House, VA 23002-3410
Mailing Address8631 Namozine RdAmelia Court House, VA 23002-3410 · (804) 561-6263
Phone(804) 561-6263
Organization SubpartNo
Authorized OfficialMary R TurnerChief Executive Officer · (434) 696-2165
Enumeration DateMarch 12, 2009
Last NPPES UpdateJuly 21, 2022
✔ NPI 1104067701 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
License✔ Licensed in VA · 0
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
8631 NAMOZINE RD, Amelia Court House, VA 23002
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D0231234

Southern Dominion Health System, Inc Lunenburg Medical Center · Victoria, VA
Active · expires Dec 22, 2027
CLIA Number49D0231234
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateDecember 23, 2025
Certificate Expiration DateDecember 22, 2027
Laboratory DirectorMargaret K. Inge
Laboratory Phone(434) 696-2165
Laboratory LocationSouthern Dominion Health System, Inc Lunenburg Medical Center1508 K-V Road, Victoria, VA 23974
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY F BASCO MD
Internal Medicine
8631 NAMOZINE RD
AMELIA COURT HOUSE, VA 23002
Amelia County (804) 561-4333

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Dominion Health System's NPI number?

The NPI number for Southern Dominion Health System is 1104067701. It was assigned to this organization in the NPPES registry on March 12, 2009.

Where is Southern Dominion Health System located?

Southern Dominion Health System is located at 8631 Namozine Rd, Amelia Court House, VA 23002. The listed phone number is (804) 561-6263.

What is Southern Dominion Health System's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Southern Dominion Health System hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 49D0231234) is associated with this NPI, valid through December 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southern Dominion Health System was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.