49D1026247 CLIA NUMBER - WESTSIDE MEDICAL, PC

Laboratory Demographics

  • CLIA Code: 49D1026247
  • Facility Name: WESTSIDE MEDICAL, PC
  • Facility Address: 1601-B OLDE WILLIAM STREET
    FREDERICKSBURG, VA
    ZIP 22401
  • Facility Phone: 540 702-8320
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW J. HENGY
  • NPI Number: 1306875497
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D1026247
LAB Type Physician Office
Facility Name WESTSIDE MEDICAL, PC
Street 1601-B OLDE WILLIAM STREET
City FREDERICKSBURG
State VA
ZIP 22401
Phone 540 702-8320
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/28/2024
Certificate Expiration Date 5/27/2026
Facility Type Physician Office
Lab Director MATTHEW J. HENGY

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