49D1037374 CLIA NUMBER - VAN DORN PEDIATRICS AND ADOLESCENT

Laboratory Demographics

  • CLIA Code: 49D1037374
  • Facility Name: VAN DORN PEDIATRICS AND ADOLESCENT
  • Facility Address: 2500 N VAN DORN STREET - SUITE 102
    ALEXANDRIA, VA
    ZIP 22302
  • Facility Phone: 703 933-0555
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOHEB S. ANDDRAWIS
  • NPI Number: 1639379159
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D1037374
LAB Type Physician Office
Facility Name VAN DORN PEDIATRICS AND ADOLESCENT
Street 2500 N VAN DORN STREET - SUITE 102
City ALEXANDRIA
State VA
ZIP 22302
Phone 703 933-0555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2025
Certificate Expiration Date 2/22/2027
Facility Type Physician Office
Lab Director MOHEB S. ANDDRAWIS

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