49D0860180 CLIA NUMBER - CHANTILLY WALK-IN CLINIC

Laboratory Demographics

  • CLIA Code: 49D0860180
  • Facility Name: CHANTILLY WALK-IN CLINIC
  • Facility Address: 14016-C SULLYFIELD CIRCLE
    CHANTILLY, VA
    ZIP 20151
  • Facility Phone: 703 631-0791
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAMIR NAZAM
  • NPI Number: 1972509735
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D0860180
LAB Type Physician Office
Facility Name CHANTILLY WALK-IN CLINIC
Street 14016-C SULLYFIELD CIRCLE
City CHANTILLY
State VA
ZIP 20151
Phone 703 631-0791
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 SAMIR NAZAM

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