PEDIATRIC DEPARTMENT LABORATORY
NPI 1588863385
Clinical Medical Laboratory in Salem, VA

NPI Status: Active since July 12, 2007

Contact Information

1802 BRAEBURN DR
SALEM, VA
ZIP 24153
Phone: (540) 772-5962

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  • Organization
  • Clinical Medical Laboratory
  • CLIA Number: 49D0669350
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-31-2027

About PEDIATRIC DEPARTMENT LABORATORY

This page provides the complete NPI Profile along with additional information for Pediatric Department Laboratory, a provider established in Salem, Virginia operating as a Clinical Medical Laboratory. The healthcare provider is registered in the NPI registry with number 1588863385 assigned on July 2007. The practitioner's primary taxonomy code is 291U00000X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's other name is Pediatric Department Laboratory. The authorized official of this NPI record is Otis W. Blackwood (Practice Administrator)

NPI
1588863385
Provider Legal Name
LEWIS-GALE PHYSICIANS, LLC
Other Organization Name
PEDIATRIC DEPARTMENT LABORATORY
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
1802 BRAEBURN DR SALEM, VA 24153
Location Phone
(540) 772-5962
Mailing Address
1802 BRAEBURN DR SALEM, VA 24153
Mailing Phone
(540) 772-5962
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-12-2007
Last Update Date
08-22-2020
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Establishments like Pediatric Department Laboratory are healthcare facilities that may perform a wide range of laboratory procedures, assisted by doctors and medical technologists. Laboratories can be categorized according to their function as common diagnostic labs or specialty labs that conduct specialized or confirmatory tests. Different clinical laboratories could specialize in clinical chemistry, clinical microbiology, hematology, serology, clinical microscopy, cytopathology, molecular biology, or public health. Please inquire directly with this provider to confirm their test menu.

Clinical labs in the U.S. that perform human testing are regulated by the Centers for Medicare & Medicaid Services (CMS) through the Clinical Laboratory Improvement Amendments (CLIA) program. The purpose of the CLIA program is to guarantee the quality of laboratory testing. This provider has a CLIA number assigned, and undergoes regular inspections to ensure compliance and quality.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinical Medical Laboratory

Taxonomy Code
291U00000X
Type
Laboratories
Taxonomy Description
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

OTIS W. BLACKWOOD

Authorized Official Title
PRACTICE ADMINISTRATOR
Authorized Official Phone
(540) 772-5995

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
49D0669350
Facility Type
Physician Office
Certificate Effective Date
September 01, 2025
Certificate Expiration Date
August 31, 2027
Laboratory Director
JOYCE CUMMINGS
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Pediatric Department Laboratory to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1588863385, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 75. The final step is to find the difference between that total and the next multiple of ten (80 - 75 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
8
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
6
Unchanged
Pos 7
3
Doubled → 6
Pos 8
3
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 8 → 16 → 7 3 → 6 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 6 + 8 + 1 + 6 + 6 + 6 + 3 + 1 + 6 + 24 = 75

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 75 is 80. The difference is the calculated check digit.

80 - 75 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1588863385.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

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Physician Assistant (Surgical)
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Specialist
1802 BRAEBURN DR
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Pediatrics
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Psychiatry & Neurology (Neurology)
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Dermatology
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Internal Medicine (Pulmonary Disease)
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Ophthalmology
1802 BRAEBURN DR
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Obstetrics & Gynecology (Gynecology)
1802 BRAEBURN DR
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Internal Medicine
1802 BRAEBURN DR
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Internal Medicine (Cardiovascular Disease)
1802 BRAEBURN DR
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Pediatrics
1802 BRAEBURN DR
SALEM, VA 24153
Pediatrics
1802 BRAEBURN DR
SALEM, VA 24153
Orthopaedic Surgery
1802 BRAEBURN DR
SALEM, VA 24153

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1588863385, enumerated as an "organization" on July 12, 2007.

The provider is located at 1802 BRAEBURN DR SALEM, VA 24153 and the phone number is (540) 772-5962.

Clinical Medical Laboratory with taxonomy code 291U00000X.