49D1074750 CLIA NUMBER - NOVA MEDICAL SERVICES, PLLC

Laboratory Demographics

  • CLIA Code: 49D1074750
  • Facility Name: NOVA MEDICAL SERVICES, PLLC
  • Facility Address: 43130 AMBERWOOD PLAZA - SUITE 240
    SOUTH RIDING, VA
    ZIP 20152
  • Facility Phone: 703 961-1119
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NEERAJA THATHAGARI, MD
  • NPI Number: 1679692974
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D1074750
LAB Type Physician Office
Facility Name NOVA MEDICAL SERVICES, PLLC
Street 43130 AMBERWOOD PLAZA - SUITE 240
City SOUTH RIDING
State VA
ZIP 20152
Phone 703 961-1119
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2024
Certificate Expiration Date 4/30/2026
Facility Type Physician Office
Lab Director NEERAJA THATHAGARI, MD

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