49D1037007 CLIA NUMBER - HISPANIC AMERICAN PEDIATRIC ASSOCIATES

Laboratory Demographics

  • CLIA Code: 49D1037007
  • Facility Name: HISPANIC AMERICAN PEDIATRIC ASSOCIATES
  • Facility Address: 5130 DUKE STREET - SUITE 7
    ALEXANDRIA, VA
    ZIP 22304
  • Facility Phone: 703 751-2021
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEMAL OMIDVAR
  • NPI Number: 1386719524
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D1037007
LAB Type Physician Office
Facility Name HISPANIC AMERICAN PEDIATRIC ASSOCIATES
Street 5130 DUKE STREET - SUITE 7
City ALEXANDRIA
State VA
ZIP 22304
Phone 703 751-2021
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2025
Certificate Expiration Date 2/13/2027
Facility Type Physician Office
Lab Director JEMAL OMIDVAR

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