49D1018980 CLIA NUMBER - SENTARA FAMILY & INTERNAL MEDICINE PHYSICIANS - WOODBRIDGE

Laboratory Demographics

  • CLIA Code: 49D1018980
  • Facility Name: SENTARA FAMILY & INTERNAL MEDICINE PHYSICIANS - WOODBRIDGE
  • Facility Address: 4500 POND WAY, SUITE 170
    WOODBRIDGE, VA
    ZIP 22192
  • Facility Phone: 571 542-4955
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAENELL C. WILLIAMS
  • NPI Number: 1346601309
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D1018980
LAB Type Physician Office
Facility Name SENTARA FAMILY & INTERNAL MEDICINE PHYSICIANS - WOODBRIDGE
Street 4500 POND WAY, SUITE 170
City WOODBRIDGE
State VA
ZIP 22192
Phone 571 542-4955
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Physician Office
Lab Director RAENELL C. WILLIAMS

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