21D2011623 CLIA NUMBER - OSCAR F SUGASTTI, MD LLC

Laboratory Demographics

  • CLIA Code: 21D2011623
  • Facility Name: OSCAR F SUGASTTI, MD LLC
  • Facility Address: 2200 OPITZ BOULEVARD, SUITE 355-375
    WOODBRIDGE, VA
    ZIP 22191
  • Facility Phone: 703 580-6400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. OSCAR SUGASTTI
  • NPI Number: 1255330759
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D2011623
LAB Type Physician Office
Facility Name OSCAR F SUGASTTI, MD LLC
Street 2200 OPITZ BOULEVARD, SUITE 355-375
City WOODBRIDGE
State VA
ZIP 22191
Phone 703 580-6400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2024
Certificate Expiration Date 8/18/2026
Facility Type Physician Office
Lab Director DR. OSCAR SUGASTTI

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This page was last updated on: 3/20/2025