49D0222391 CLIA NUMBER - NORTHERN VIRGINIA PEDIATRIC ASSOCIATES, PC

Laboratory Demographics

  • CLIA Code: 49D0222391
  • Facility Name: NORTHERN VIRGINIA PEDIATRIC ASSOCIATES, PC
  • Facility Address: 107 N VIRGINIA AVE
    FALLS CHURCH, VA
    ZIP 22046
  • Facility Phone: 703 532-4446
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELY G. MOUCHAHOIR
  • NPI Number: 1780888776
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 49D0222391
LAB Type Physician Office
Facility Name NORTHERN VIRGINIA PEDIATRIC ASSOCIATES, PC
Street 107 N VIRGINIA AVE
City FALLS CHURCH
State VA
ZIP 22046
Phone 703 532-4446
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Physician Office
Lab Director ELY G. MOUCHAHOIR

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