09D2033464 CLIA NUMBER - IMMACULATE MEDICAL SERVICES

Laboratory Demographics

  • CLIA Code: 09D2033464
  • Facility Name: IMMACULATE MEDICAL SERVICES
  • Facility Address: 106 IRVING STREET NW, SUITE 308 SOUTH
    WASHINGTON, DC
    ZIP 20010
  • Facility Phone: 202 877-0400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ANN MARIE GORDON
  • NPI Number: 1821301904
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 09D2033464
LAB Type Physician Office
Facility Name IMMACULATE MEDICAL SERVICES
Street 106 IRVING STREET NW, SUITE 308 SOUTH
City WASHINGTON
State DC
ZIP 20010
Phone 202 877-0400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Physician Office
Lab Director DR. ANN MARIE GORDON

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025