49D0863267 CLIA NUMBER - INTERNAL MEDICINE PRACTICE PC

Laboratory Demographics

  • CLIA Code: 49D0863267
  • Facility Name: INTERNAL MEDICINE PRACTICE PC
  • Facility Address: 8233 A OLD COURT HOUSE ROAD - SUITE 170
    VIENNA, VA
    ZIP 22182
  • Facility Phone: 703 556-9318
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SANDRA TIRADO
  • NPI Number: 1013121508
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D0863267
LAB Type Physician Office
Facility Name INTERNAL MEDICINE PRACTICE PC
Street 8233 A OLD COURT HOUSE ROAD - SUITE 170
City VIENNA
State VA
ZIP 22182
Phone 703 556-9318
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 SANDRA TIRADO

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