SOUTHEASTERN VIRGINIA HEALTH SYSTEM AT WESTERN TIDEWATER COMMUNITY SER
NPI 1720462294
Clinic/Center - Federally Qualified Health Center (FQHC) in Suffolk, VA
About Southeastern Virginia Health System At Western Tidewater Community Ser NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHEASTERN VIRGINIA HEALTH SYSTEM AT WESTERN TIDEWATER COMMUNITY SER (NPI 1720462294) is a healthcare organization registered as a federally qualified health center (fqhc) in Suffolk, Virginia and active in the NPI registry since July 2015. The organization holds a CLIA Waiver certificate valid through October 14, 2027 and lists Angela Futrell, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
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
- 49D2173520
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- October 15, 2025
- Certificate Expiration Date
- October 14, 2027
- Laboratory Director
- ELIZABETH WEBSTER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Southeastern Virginia Health System At Western Tidewater Community Ser 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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Other Providers at the Same Location
The following 14 providers are registered at the same or a nearby location.
SUFFOLK, VA 23434
SUFFOLK, VA 23434
SUFFOLK, VA 23434
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1720462294, enumerated as an "organization" on July 15, 2015.
The provider is located at 5268 GODWIN BLVD SUFFOLK, VA 23434 and the phone number is (757) 255-7133.
Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).
