49D1086545 CLIA NUMBER - PRINCE WILLIAM DERMATOLOGY, PC

Laboratory Demographics

  • CLIA Code: 49D1086545
  • Facility Name: PRINCE WILLIAM DERMATOLOGY, PC
  • Facility Address: 7051 HEATHCOTE VILLAGE WAY, SUITE 210
    GAINESVILLE, VA
    ZIP 20155
  • Facility Phone: 571 261-1234
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: CUONG T. HA
  • NPI Number: 1508046293
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 49D1086545
LAB Type Physician Office
Facility Name PRINCE WILLIAM DERMATOLOGY, PC
Street 7051 HEATHCOTE VILLAGE WAY, SUITE 210
City GAINESVILLE
State VA
ZIP 20155
Phone 571 261-1234
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 7/23/2025
Certificate Expiration Date 7/22/2027
Facility Type Physician Office
Lab Director CUONG T. HA

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