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

Laboratory Demographics

  • CLIA Code: 49D0222254
  • Facility Name: CISSY P POTTANAT, MD, MPH
  • Facility Address: 7115 LEESBURG PIKE, UNIT 211
    FALLS CHURCH, VA
    ZIP 22043
  • Facility Phone: 703 532-1111
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CISSY P. POTTANAT, MD, MPH
  • NPI Number: 1295802718
  • Taxonomy: 207Q00000X - Family Medicine

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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
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 5/15/2024
Certificate Expiration Date 5/14/2026
Facility Type Physician Office
Lab Director CISSY P. POTTANAT, MD, MPH

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