49D1096055 CLIA NUMBER - ELDEN ST PEDIATRICS

Laboratory Demographics

  • CLIA Code: 49D1096055
  • Facility Name: ELDEN ST PEDIATRICS
  • Facility Address: 110 ELDEN STREET - SUITE D
    HERNDON, VA
    ZIP 20170
  • Facility Phone: 703 471-6996
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SITHU WIN
  • NPI Number: 1215091038
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 49D1096055
LAB Type Physician Office
Facility Name ELDEN ST PEDIATRICS
Street 110 ELDEN STREET - SUITE D
City HERNDON
State VA
ZIP 20170
Phone 703 471-6996
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2025
Certificate Expiration Date 2/23/2027
Facility Type Physician Office
Lab Director SITHU WIN

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