49D0691113 CLIA NUMBER - MARC EISENBAUM MD

Laboratory Demographics

  • CLIA Code: 49D0691113
  • Facility Name: MARC EISENBAUM MD
  • Facility Address: 3700 JOSEPH SIEWICK DRIVE SUITE 203
    FAIRFAX, VA
    ZIP 22033
  • Facility Phone: 703 758-8200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARC EISENBAUM MD
  • NPI Number: 1083710008
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D0691113
LAB Type Physician Office
Facility Name MARC EISENBAUM MD
Street 3700 JOSEPH SIEWICK DRIVE SUITE 203
City FAIRFAX
State VA
ZIP 22033
Phone 703 758-8200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director MARC EISENBAUM MD

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