49D0221831 CLIA NUMBER - FAIRFAX SURGICAL CENTER

Laboratory Demographics

  • CLIA Code: 49D0221831
  • Facility Name: FAIRFAX SURGICAL CENTER
  • Facility Address: 10730 MAIN STREET
    FAIRFAX, VA
    ZIP 22030
  • Facility Phone: 703 691-0670
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ANDREW Y. KIM
  • NPI Number: 1477516979
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D0221831
LAB Type Ambulatory Surgery Center
Facility Name FAIRFAX SURGICAL CENTER
Street 10730 MAIN STREET
City FAIRFAX
State VA
ZIP 22030
Phone 703 691-0670
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Ambulatory Surgery Center
Lab Director ANDREW Y. KIM

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