49D1053183 CLIA NUMBER - GARRISONVILLE DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 49D1053183
  • Facility Name: GARRISONVILLE DIALYSIS CENTER
  • Facility Address: 70 DOC STONE RD 101
    STAFFORD, VA
    ZIP 22556
  • Facility Phone: 240 893-2521
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: NOWAL AL BAQUI
  • NPI Number: 1972580751
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D1053183
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name GARRISONVILLE DIALYSIS CENTER
Street 70 DOC STONE RD 101
City STAFFORD
State VA
ZIP 22556
Phone 240 893-2521
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/17/2024
Certificate Expiration Date 4/16/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director NOWAL AL BAQUI

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This page was last updated on: 6/4/2025