49D0883908 CLIA NUMBER - ARLEIGH BURKE PAVILION

Laboratory Demographics

  • CLIA Code: 49D0883908
  • Facility Name: ARLEIGH BURKE PAVILION
  • Facility Address: 1739 KIRBY ROAD
    MC LEAN, VA
    ZIP 22101
  • Facility Phone: 703 506-6900
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CISSY POTTANAT
  • NPI Number: 1992093553
  • Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 49D0883908
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ARLEIGH BURKE PAVILION
Street 1739 KIRBY ROAD
City MC LEAN
State VA
ZIP 22101
Phone 703 506-6900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/31/2025
Certificate Expiration Date 5/30/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CISSY POTTANAT

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