49D0222254 CLIA NUMBER - CISSY P POTTANAT, MD, MPH

Laboratory Demographics

CLIA Number: 49D0222254

Facility Name: CISSY P POTTANAT, MD, MPH

Facility Address:
7115 LEESBURG PIKE, UNIT 211
FALLS CHURCH, VA
ZIP 22043
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Facility Phone Number: 703 532-1111

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1295802718

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	49D0222254
LAB Type	Physician Office
Facility Name	CISSY P POTTANAT, MD, MPH
Street	7115 LEESBURG PIKE, UNIT 211
City	FALLS CHURCH
State	VA
ZIP	22043
Phone	703 532-1111
CertificateType	3
CertificateEffectiveDate	5/15/2024
CertificateExpirationDate	5/14/2026
FacilityType	PPMP

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This page was last updated on: 4/23/2024