49D0976746 CLIA NUMBER - FAIR RIDGE OB/GYN ASSOCIATES, PC

Laboratory Demographics

  • CLIA Code: 49D0976746
  • Facility Name: FAIR RIDGE OB/GYN ASSOCIATES, PC
  • Facility Address: 13135 LEE JACKSON MEMORIAL HWY #301
    FAIRFAX, VA
    ZIP 22033
  • Facility Phone: 703 264-3801
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: WALTER J. HODGES
  • NPI Number: 1043392434
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 49D0976746
LAB Type Physician Office
Facility Name FAIR RIDGE OB/GYN ASSOCIATES, PC
Street 13135 LEE JACKSON MEMORIAL HWY #301
City FAIRFAX
State VA
ZIP 22033
Phone 703 264-3801
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 8/14/2024
Certificate Expiration Date 8/13/2026
Facility Type Physician Office
Lab Director WALTER J. HODGES

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