PREMISE HEALTH OF VIRGINIA MEDICAL PC
NPI 1104300078
Clinic/Center - Multi-Specialty in Blacksburg, VA

Active since September 18, 2018CLIA 49D2156735 · Waiver
1301 N MAIN ST, BLACKSBURG, VA 24060(844) 342-1757(262) 372-5604 Get Directions Write a Review

NPPES record last updated: February 2, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 2, 2026, Aug 15, 2022, Jul 14, 2022 and 2 more (5 updates tracked since 2018).

About Premise Health Of Virginia Medical Pc NPPES

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

PREMISE HEALTH OF VIRGINIA MEDICAL PC (NPI 1104300078), doing business as Moog Inhealth Wellness Center, is a healthcare organization registered as a multi-specialty in Blacksburg, Virginia and active in the NPI registry since September 2018. The organization holds a CLIA Waiver certificate valid through October 23, 2026 and lists Edward William Schwartz, President, as its authorized official.

NPPES Registry Identity

NPI1104300078
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NamePREMISE HEALTH OF VIRGINIA MEDICAL PC
Location Address1301 N MAIN STBlacksburg, VA 24060-3129
Mailing Address5500 Maryland Way Ste 120Brentwood, TN 37027-4993
Fax(262) 372-5604
Organization SubpartNo
Authorized OfficialEdward William SchwartzPresident · (844) 407-7557
Enumeration DateSeptember 18, 2018
Last NPPES UpdateFebruary 2, 20265 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2026
NPI 1104300078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
1301 N MAIN ST, Blacksburg, VA 24060

Other Names 1

Doing Business AsMoog Inhealth Wellness Center

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 of Waiver 49D2156735

Premise Health Of Virginia Medical PC · Blacksburg, VA
Active · expires Oct 23, 2026
CLIA Number49D2156735
Laboratory TypePhysician Office
Certificate Effective DateOctober 24, 2024
Certificate Expiration DateOctober 23, 2026
Laboratory DirectorMaria Pielaet
Laboratory Phone(540) 739-2044
Laboratory LocationPremise Health Of Virginia Medical PC1301 North Main Street, Blacksburg, VA 24060
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only 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.

Pharmacist
1301 N MAIN ST
BLACKSBURG, VA 24060

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 Premise Health Of Virginia Medical PC's NPI number?

The NPI number for Premise Health Of Virginia Medical PC is 1104300078. It was assigned to this organization in the NPPES registry on September 18, 2018. The provider is doing business as Moog InHealth Wellness Center.

Where is Premise Health Of Virginia Medical PC located?

Premise Health Of Virginia Medical PC is located at 1301 N Main St, Blacksburg, VA 24060. The listed phone number is (844) 342-1757.

What is Premise Health Of Virginia Medical PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Premise Health Of Virginia Medical PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2156735) is associated with this NPI, valid through October 23, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Premise Health Of Virginia Medical PC was last updated on February 2, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.