49D2000901 CLIA NUMBER - MILLENNIUM MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 49D2000901
  • Facility Name: MILLENNIUM MEDICAL CENTER
  • Facility Address: 6319 CASTLE PLACE, SUITE 2C
    FALLS CHURCH, VA
    ZIP 22044
  • Facility Phone: 703 820-7520
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHAYMA AL-MUDHAFAR
  • NPI Number: 1689909897
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D2000901
LAB Type Physician Office
Facility Name MILLENNIUM MEDICAL CENTER
Street 6319 CASTLE PLACE, SUITE 2C
City FALLS CHURCH
State VA
ZIP 22044
Phone 703 820-7520
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2023
Certificate Expiration Date 12/7/2025
Facility Type Physician Office
Lab Director SHAYMA AL-MUDHAFAR

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