49D0223740 CLIA NUMBER - PEDIATRIC GROUP PC AT LAKE RIDGE,THE

Laboratory Demographics

  • CLIA Code: 49D0223740
  • Facility Name: PEDIATRIC GROUP PC AT LAKE RIDGE,THE
  • Facility Address: 13001 SUMMIT SCHOOL ROAD
    WOODBRIDGE, VA
    ZIP 22192
  • Facility Phone: 703 690-3119
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELIZABETH PALUMBO, MD
  • NPI Number: 1720330277
  • Taxonomy: 174400000X - Specialist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 49D0223740
LAB Type Physician Office
Facility Name PEDIATRIC GROUP PC AT LAKE RIDGE,THE
Street 13001 SUMMIT SCHOOL ROAD
City WOODBRIDGE
State VA
ZIP 22192
Phone 703 690-3119
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 ELIZABETH PALUMBO, MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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