49D1018307 CLIA NUMBER - BROADLANDS FAMILY MEDICINE- ASHBURN

Laboratory Demographics

  • CLIA Code: 49D1018307
  • Facility Name: BROADLANDS FAMILY MEDICINE- ASHBURN
  • Facility Address: 20905 PROFESSIONAL PLAZA - SUITE 330
    ASHBURN, VA
    ZIP 20147
  • Facility Phone: 703 726-0003
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: EMILY FALTEMIER
  • NPI Number: 1215264916
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D1018307
LAB Type Physician Office
Facility Name BROADLANDS FAMILY MEDICINE- ASHBURN
Street 20905 PROFESSIONAL PLAZA - SUITE 330
City ASHBURN
State VA
ZIP 20147
Phone 703 726-0003
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 3/30/2024
Certificate Expiration Date 3/29/2026
Facility Type Physician Office
Lab Director EMILY FALTEMIER

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