49D0222068 CLIA NUMBER - INOVA PRIMARY CARE- FAIR OAKS

Laboratory Demographics

  • CLIA Code: 49D0222068
  • Facility Name: INOVA PRIMARY CARE- FAIR OAKS
  • Facility Address: 3650 JOSEPH SIEWICK DR SUITE 101, 203 & 400
    FAIRFAX, VA
    ZIP 22033
  • Facility Phone: 703 391-2020
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: THOMAS EHRILCH
  • NPI Number: 1205944964
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D0222068
LAB Type Physician Office
Facility Name INOVA PRIMARY CARE- FAIR OAKS
Street 3650 JOSEPH SIEWICK DR SUITE 101, 203 & 400
City FAIRFAX
State VA
ZIP 22033
Phone 703 391-2020
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/30/2025
Certificate Expiration Date 3/29/2027
Facility Type Physician Office
Lab Director THOMAS EHRILCH

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