49D0717098 CLIA NUMBER - CDC OF WOODBRIDGE

Laboratory Demographics

  • CLIA Code: 49D0717098
  • Facility Name: CDC OF WOODBRIDGE
  • Facility Address: 2751 KILLARNEY DRIVE
    WOODBRIDGE, VA
    ZIP 22192
  • Facility Phone: 703 494-5168
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: KOUROSH DIBADJ
  • NPI Number: 1386608586
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D0717098
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name CDC OF WOODBRIDGE
Street 2751 KILLARNEY DRIVE
City WOODBRIDGE
State VA
ZIP 22192
Phone 703 494-5168
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 End Stage Renal Disease Dialysis Facility
Lab Director KOUROSH DIBADJ

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