49D0992560 CLIA NUMBER - LOUDOUN VALLEY FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 49D0992560
  • Facility Name: LOUDOUN VALLEY FAMILY PRACTICE
  • Facility Address: 205 E HIRST ROAD, SUITE 200
    PURCELLVILLE, VA
    ZIP 20132
  • Facility Phone: 540 338-6101
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JESSICA GOOD
  • NPI Number: 1609302645
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D0992560
LAB Type Physician Office
Facility Name LOUDOUN VALLEY FAMILY PRACTICE
Street 205 E HIRST ROAD, SUITE 200
City PURCELLVILLE
State VA
ZIP 20132
Phone 540 338-6101
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2023
Certificate Expiration Date 10/18/2025
Facility Type Physician Office
Lab Director JESSICA GOOD

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This page was last updated on: 6/4/2025