49D1018324 CLIA NUMBER - AMY L FRIEDENTHAL, MD, PC

Laboratory Demographics

  • CLIA Code: 49D1018324
  • Facility Name: AMY L FRIEDENTHAL, MD, PC
  • Facility Address: 12512 LAKE RIDGE DRIVE - D
    WOODBRIDGE, VA
    ZIP 22192
  • Facility Phone: 703 497-5555
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: AMY L. FRIEDENTHAL, MD
  • NPI Number: 1427176999
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D1018324
LAB Type Physician Office
Facility Name AMY L FRIEDENTHAL, MD, PC
Street 12512 LAKE RIDGE DRIVE - D
City WOODBRIDGE
State VA
ZIP 22192
Phone 703 497-5555
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 10/20/2025
Certificate Expiration Date 10/19/2027
Facility Type Physician Office
Lab Director AMY L. FRIEDENTHAL, MD

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