49D1082160 CLIA NUMBER - PRIMEDOC FAIRFAX

Laboratory Demographics

  • CLIA Code: 49D1082160
  • Facility Name: PRIMEDOC FAIRFAX
  • Facility Address: 12011 LEE JACKSON MEMORIAL HIGHWAY - SUITE 102
    FAIRFAX, VA
    ZIP 22033
  • Facility Phone: 703 385-8378
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HARUTYUN HAROYAN
  • NPI Number: 1316151343
  • Taxonomy: 261QV0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D1082160
LAB Type Physician Office
Facility Name PRIMEDOC FAIRFAX
Street 12011 LEE JACKSON MEMORIAL HIGHWAY - SUITE 102
City FAIRFAX
State VA
ZIP 22033
Phone 703 385-8378
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2024
Certificate Expiration Date 4/1/2026
Facility Type Physician Office
Lab Director HARUTYUN HAROYAN

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