49D0912609 CLIA NUMBER - TOWN CENTER FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 49D0912609
  • Facility Name: TOWN CENTER FAMILY MEDICINE
  • Facility Address: 11800 SUNRISE VALLEY DRIVE - SUITE 700
    RESTON, VA
    ZIP 20191
  • Facility Phone: 703 834-1473
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CRAIG C. CLARK, MD
  • NPI Number: 1417071697
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D0912609
LAB Type Physician Office
Facility Name TOWN CENTER FAMILY MEDICINE
Street 11800 SUNRISE VALLEY DRIVE - SUITE 700
City RESTON
State VA
ZIP 20191
Phone 703 834-1473
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Physician Office
Lab Director CRAIG C. CLARK, MD

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