49D0223634 CLIA NUMBER - SENTARA INTERNAL MEDICINE PHYSICIANS WOODBRIDGE

Laboratory Demographics

  • CLIA Code: 49D0223634
  • Facility Name: SENTARA INTERNAL MEDICINE PHYSICIANS WOODBRIDGE
  • Facility Address: 2280 OPITZ BLVD SUITE 250
    WOODBRIDGE, VA
    ZIP 22191
  • Facility Phone: 703 523-1720
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TARA A. KHOSHNAW
  • NPI Number: 1790053965
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D0223634
LAB Type Physician Office
Facility Name SENTARA INTERNAL MEDICINE PHYSICIANS WOODBRIDGE
Street 2280 OPITZ BLVD SUITE 250
City WOODBRIDGE
State VA
ZIP 22191
Phone 703 523-1720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2024
Certificate Expiration Date 5/20/2026
Facility Type Physician Office
Lab Director TARA A. KHOSHNAW

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