49D0222027 CLIA NUMBER - CHILDREN'S MEDICAL ASSOCIATES OF NOVA

Laboratory Demographics

  • CLIA Code: 49D0222027
  • Facility Name: CHILDREN'S MEDICAL ASSOCIATES OF NOVA
  • Facility Address: 10615 BRADDOCK RD #200
    FAIRFAX, VA
    ZIP 22032
  • Facility Phone: 703 691-4700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROMAN KISHI
  • NPI Number: 1578292496
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D0222027
LAB Type Physician Office
Facility Name CHILDREN'S MEDICAL ASSOCIATES OF NOVA
Street 10615 BRADDOCK RD #200
City FAIRFAX
State VA
ZIP 22032
Phone 703 691-4700
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 ROMAN KISHI

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