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49D0678543 CLIA NUMBER - JOHN J BASILE MD PC

Laboratory Demographics

CLIA Number: 49D0678543

Facility Name: JOHN J BASILE MD PC

Facility Address:
3020 HAMAKER COURT SUITE B 111
FAIRFAX, VA
ZIP 22031
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Facility Phone Number: 703 876-0288

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1548235732

Taxonomy: 208800000X - Urology
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

CLIA Record

Field Name Field Value
CLIA Number 49D0678543
LAB Type Physician Office
Facility Name JOHN J BASILE MD PC
Street 3020 HAMAKER COURT SUITE B 111
City FAIRFAX
State VA
ZIP 22031
Phone 703 876-0288
CertificateType 3
CertificateEffectiveDate 9/1/2022
CertificateExpirationDate 8/31/2024
FacilityType PPMP

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