SENTARA CLARKSVILLE FAMILY MEDICINE - NPI 1669572897 - Legal Medicine in Clarksville, VA

Q: What is Dominion Health Medical Assoc's NPI number?

The NPI number for Dominion Health Medical Assoc is 1669572897. It was assigned to this organization in the NPPES registry on September 25, 2006. The provider is doing business as Sentara Clarksville Family Medicine.

Q: What is Dominion Health Medical Assoc's specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

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About Sentara Clarksville Family Medicine NPPES

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

SENTARA CLARKSVILLE FAMILY MEDICINE (NPI 1669572897) is a healthcare organization registered as a legal medicine in Clarksville, Virginia and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through January 31, 2027 and lists Cecil Hazelwood, Manager (sdhg), as its authorized official.

NPPES Registry Identity

NPI1669572897

Entity TypeOrganization

Primary Taxonomy173000000X

Legal Business NameDOMINION HEALTH MEDICAL ASSOC

Location Address115 COLLEGE STClarksville, VA 23927

Mailing AddressP.o. Box 860South Boston, VA 24592 · (434) 517-3513 · Fax (434) 517-3887

Phone(434) 374-5344

Fax(434) 517-3887

Organization SubpartNo

Authorized OfficialCecil HazelwoodManager (sdhg) · (434) 517-3515

Enumeration DateSeptember 25, 2006

Last NPPES UpdateFebruary 11, 2015

✔ NPI 1669572897 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLegal MedicineOther Service Providers

Taxonomy Code173000000X

License✔ Licensed in VA · 0101032102

Definition

The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.

115 COLLEGE ST, Clarksville, VA 23927

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Other Names 1

Doing Business AsSentara Clarksville Family Medicine

Other Identifiers 1

Medicare ID-Type UnspecifiedC04633VA · Group Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 49D0231172

Sentara Clarksville Family Medicine · Clarksville, VA

Active · expires Jan 31, 2027

CLIA Number49D0231172

Laboratory TypePhysician Office

Certificate Effective DateFebruary 1, 2025

Certificate Expiration DateJanuary 31, 2027

Laboratory DirectorPablo C. Souza

Laboratory Phone(434) 517-3216

Laboratory LocationSentara Clarksville Family Medicine115 College Street, Clarksville, VA 23927

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 6

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

VIVIA BROGDEN WHITFIELD FNP

Nurse Practitioner (Family)