49D0978854 CLIA NUMBER - ENDOCRINE AND DIABETES CENTER PC

Laboratory Demographics

CLIA Number: 49D0978854

Facility Name: ENDOCRINE AND DIABETES CENTER PC

Facility Address:
301 MAPLE AVENUE W - SUTIE 120
VIENNA, VA
ZIP 22180
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Facility Phone Number: 703 938-8885

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1154487007

Taxonomy: 207RE0101X - Internal Medicine
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

CLIA Record

Field Name	Field Value
CLIA Number	49D0978854
LAB Type	Physician Office
Facility Name	ENDOCRINE AND DIABETES CENTER PC
Street	301 MAPLE AVENUE W - SUTIE 120
City	VIENNA
State	VA
ZIP	22180
Phone	703 938-8885
CertificateType	4
CertificateEffectiveDate	10/4/2022
CertificateExpirationDate	10/3/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024