49D0908017 CLIA NUMBER - GAINESVILLE FAMILY PRACTICE, PC

Laboratory Demographics

  • CLIA Code: 49D0908017
  • Facility Name: GAINESVILLE FAMILY PRACTICE, PC
  • Facility Address: 7915 LAKE MANASSAS DRIVE, SUITE 102
    GAINESVILLE, VA
    ZIP 20155
  • Facility Phone: 703 754-4101
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JASON V. HACKETT MD
  • NPI Number: 1871589770
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D0908017
LAB Type Physician Office
Facility Name GAINESVILLE FAMILY PRACTICE, PC
Street 7915 LAKE MANASSAS DRIVE, SUITE 102
City GAINESVILLE
State VA
ZIP 20155
Phone 703 754-4101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2024
Certificate Expiration Date 12/31/2025
Facility Type Physician Office
Lab Director JASON V. HACKETT MD

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