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Start a clinic / Virginia

How to start a medical clinic in Virginia.

What a founder needs to know in Virginia: who can own a practice, which state approvals apply, how nurse practitioners and PAs can work, and where to register. Every fact links to its source.

Updated October 2026Sources linked
VAVirginiaStarting a clinic, at a glance
Corporate practice of medicine
UnclearNo clear official statement found
Certificate of need program
YesState review for some facilities or equipment
Nurse practitioner authority
Restricted practiceAANP classification
Register your business with
Virginia State Corporation Commission, Clerk's Office
Checked October 2026

Ownership: Virginia's professional corporation law requires shareholders to be licensed or legally authorized professionals, and a healing arts professional corporation may combine different licensed practitioners (including APRNs).

Certificate of need: Virginia has a Certificate of Public Need (COPN) program run by VDH.

Nurse practitioners: AANP classifies Virginia as restricted practice: NPs must have a practice agreement with a patient care team physician, but an NP with at least three years of full-time clinical experience and an attestation from a physician or attesting NP may apply to the Boards of Medicine and Nursing to practice autonomously.

Who can own a medical clinic in Virginia

Virginia's professional corporation law requires shareholders to be licensed or legally authorized professionals, and a healing arts professional corporation may combine different licensed practitioners (including APRNs). We could not find a clear official statement on whether non-physicians can own a medical practice in Virginia, so confirm the structure with a healthcare attorney.

Sources: law.lis.virginia.gov, law.lis.virginia.gov

Business entity and registration

Physicians can form a professional corporation under Virginia Code Title 13.1, Chapter 7, whose shareholders must be licensed professionals; a healing arts PC may include any combination of healing arts practitioners and APRNs. Business entities are registered with the Virginia State Corporation Commission (Clerk's Office).

Sources: law.lis.virginia.gov, law.lis.virginia.gov, scc.virginia.gov

Certificate of need in Virginia

Virginia has a Certificate of Public Need (COPN) program run by VDH. Ordinary physician offices are not covered, but COPN applies to hospitals, nursing homes and specialized outpatient centers, including the portion of a physician's office developed for outpatient surgery and services such as CT, MRI, PET, cardiac catheterization and radiation therapy; adding new imaging equipment or operating rooms, or introducing a listed service, is reviewable.

Sources: law.lis.virginia.gov, vdh.virginia.gov, ncsl.org

Licenses, registrations and state agencies

VDH's Office of Licensure and Certification licenses hospitals (a category that includes outpatient surgical hospitals), nursing homes, home care organizations and hospices. Virginia Code 32.1-124 exempts an office of one or more physicians from hospital licensure unless the office is used principally for performing surgery.

Sources: vdh.virginia.gov, law.lis.virginia.gov, law.lis.virginia.gov

Virginia-specific requirements to know

Prescribers must be registered with the Virginia Prescription Monitoring Program and, until July 1, 2027, must query it when starting a new course of opioids expected to last more than seven consecutive days (from July 1, 2027 the trigger becomes benzodiazepines or opiates expected to last more than 90 days). NP autonomous practice and PA practice without an agreement each require an attestation filed with the boards. Imaging, outpatient surgery and similar projects need COPN review.

Sources: law.lis.virginia.gov, law.lis.virginia.gov, law.lis.virginia.gov

Agencies you will deal with

Nurse practitioners and physician assistants

Nurse practitioners: AANP classifies Virginia as restricted practice: NPs must have a practice agreement with a patient care team physician, but an NP with at least three years of full-time clinical experience and an attestation from a physician or attesting NP may apply to the Boards of Medicine and Nursing to practice autonomously.

Sources: aanp.org, storage.aanp.org, law.lis.virginia.gov

Physician assistants: PAs practice under a practice agreement with a patient care team physician or podiatrist (who may collaborate with no more than six PAs at a time); a 2026 law (Acts 2026, c. 418, contingent effective date) adds a path to practice without an agreement after the equivalent of three years of full-time experience in a specialty and a physician attestation filed with the Board of Medicine.

Sources: law.lis.virginia.gov, law.lis.virginia.gov

Med spas, injectables and IV therapy in Virginia

The Virginia Department of Health Professions lists Guidance Document 76-1, "Regulatory Considerations for IV Hydration Clinics and Med Spas in Virginia," effective October 8, 2026, which is the current state guidance for these businesses. Confirm the details with the state board and a healthcare attorney.

Sources: dhp.virginia.gov

Planning an aesthetic or IV business? See how to start a med spa and how to start an IV therapy business.

Step-by-step checklist in Virginia

  1. Choose your structure and check ownership rules. Decide who will own the practice and confirm it fits Virginia’s corporate practice of medicine rules. Virginia's professional corporation law requires shareholders to be licensed or legally authorized professionals, and a healing arts professional corporation may combine different licensed practitioners (including APRNs).
  2. Form the entity with the Virginia State Corporation Commission, Clerk's Office. Physicians can form a professional corporation under Virginia Code Title 13.1, Chapter 7, whose shareholders must be licensed professionals; a healing arts PC may include any combination of healing arts practitioners and APRNs.
  3. Get federal numbers. Apply for an EIN from the IRS, then a Type 2 NPI for the practice and Type 1 NPIs for each clinician through NPPES.
  4. Confirm licenses with the Virginia Board of Medicine. Every physician needs a Virginia license. Check the board’s rules for any practice registrations, supervision agreements or office requirements before opening.
  5. Check certificate of need and facility licensing. Virginia has a Certificate of Public Need (COPN) program run by VDH.
  6. Register to prescribe. Register with the DEA for controlled substances and complete any Virginia controlled substance registration and prescription monitoring program enrollment. Prescribers must be registered with the Virginia Prescription Monitoring Program and, until July 1, 2027, must query it when starting a new course of opioids expected to last more than seven consecutive days (from July 1, 2027 the trigger becomes benzodiazepines or opiates expected to last more than 90 days).
  7. Set up lab, safety and privacy basics. Get a CLIA certificate if you will run any lab tests, including waived tests, and put HIPAA privacy and security and OSHA policies in place.
  8. Enroll with Medicare, Medicaid and insurers. Enroll in Medicare through PECOS, enroll with Virginia Medicaid (DMAS, Cardinal Care) and start commercial credentialing early, because payer enrollment often takes months.
  9. Plan staffing around NP and PA rules. AANP classifies Virginia as restricted practice: NPs must have a practice agreement with a patient care team physician, but an NP with at least three years of full-time clinical experience and an attestation from a physician or attesting NP may apply to the Boards of Medicine and Nursing to practice autonomously.
  10. Launch your marketing before opening day. Claim your Google Business Profile, publish a website with online booking and start ads and content four to eight weeks before you open, so the schedule is not empty on day one.

The national steps are explained in more detail in our guide to how to start a medical clinic, and costs are broken down in how much it costs to start a clinic.

Marketing a new clinic in Virginia

New clinics usually fail on cash flow before they fail on care. The fastest fix is patients booked before opening day: a complete Google Business Profile, a website with online booking, local search ads and a few weeks of social content showing the team and the space. We run that launch for new clinics and keep it going once the doors open.

Plan your Virginia launch with us →

Important. This guide is general information checked against official and professional sources in October 2026. It is not legal advice. Rules change and details depend on your services, so confirm your plan with a healthcare attorney licensed in Virginia and with the agencies listed above.

Sources

  1. https://law.lis.virginia.gov/vacode/title13.1/chapter7/section13.1-543/
  2. https://law.lis.virginia.gov/vacode/title13.1/chapter7/section13.1-549/
  3. https://www.scc.virginia.gov/
  4. https://law.lis.virginia.gov/vacode/title32.1/chapter4/section32.1-102.1:3/
  5. https://www.vdh.virginia.gov/licensure-and-certification/the-certificate-of-public-need-program/
  6. https://www.ncsl.org/health/certificate-of-need-state-laws
  7. https://www.aanp.org/advocacy/virginia
  8. https://storage.aanp.org/www/documents/no-index/state-fact-sheets/virginia.pdf
  9. https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2957/
  10. https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2952/
  11. https://law.lis.virginia.gov/vacode/title54.1/chapter29/section54.1-2952.01/
  12. https://www.vdh.virginia.gov/licensure-and-certification/
  13. https://law.lis.virginia.gov/vacode/title32.1/chapter5/section32.1-123/
  14. https://law.lis.virginia.gov/vacode/title32.1/chapter5/section32.1-124/
  15. https://www.dhp.virginia.gov/Boards/Medicine/PractitionerResources/GuidanceDocuments/
  16. https://law.lis.virginia.gov/vacode/title54.1/chapter25.2/section54.1-2522.1/

Nearby state guides

MarylandDistrict of ColumbiaWest VirginiaKentuckyTennesseeAll states
Virginia questions

Starting a clinic in Virginia, answered.

Can a non-physician own a medical clinic in Virginia?
Virginia's professional corporation law requires shareholders to be licensed or legally authorized professionals, and a healing arts professional corporation may combine different licensed practitioners (including APRNs). We could not find a clear official statement on whether non-physicians can own a medical practice in Virginia, so confirm the structure with a healthcare attorney.
Does Virginia require a certificate of need to open a clinic?
Virginia has a Certificate of Public Need (COPN) program run by VDH. Ordinary physician offices are not covered, but COPN applies to hospitals, nursing homes and specialized outpatient centers, including the portion of a physician's office developed for outpatient surgery and services such as CT, MRI, PET, cardiac catheterization and radiation therapy; adding new imaging equipment or operating rooms, or introducing a listed service, is reviewable.
Can nurse practitioners open their own practice in Virginia?
AANP classifies Virginia as restricted practice: NPs must have a practice agreement with a patient care team physician, but an NP with at least three years of full-time clinical experience and an attestation from a physician or attesting NP may apply to the Boards of Medicine and Nursing to practice autonomously.
Who can perform Botox, laser or IV therapy in Virginia?
The Virginia Department of Health Professions lists Guidance Document 76-1, "Regulatory Considerations for IV Hydration Clinics and Med Spas in Virginia," effective October 8, 2026, which is the current state guidance for these businesses. Confirm the details with the state board and a healthcare attorney.
Where do I register a medical practice in Virginia?
Physicians can form a professional corporation under Virginia Code Title 13.1, Chapter 7, whose shareholders must be licensed professionals; a healing arts PC may include any combination of healing arts practitioners and APRNs. Business entities are registered with the Virginia State Corporation Commission (Clerk's Office).