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49D1076157 CLIA NUMBER - NORTHERN VIRGINIA INTERNAL MEDICINE & PEDIATRICS, PC

Laboratory Demographics

CLIA Number: 49D1076157

Facility Name: NORTHERN VIRGINIA INTERNAL MEDICINE & PEDIATRICS, PC

Facility Address:
2501 N GLEBE ROAD - SUITE 301
ARLINGTON, VA
ZIP 22207
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Facility Phone Number: 703 527-6664

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1942484894

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name Field Value
CLIA Number 49D1076157
LAB Type Physician Office
Facility Name NORTHERN VIRGINIA INTERNAL MEDICINE & PEDIATRICS, PC
Street 2501 N GLEBE ROAD - SUITE 301
City ARLINGTON
State VA
ZIP 22207
Phone 703 527-6664
CertificateType 4
CertificateEffectiveDate 11/6/2023
CertificateExpirationDate 11/5/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024