49D2016650 CLIA NUMBER - ADVANCED PEDIATRICS

Laboratory Demographics

  • CLIA Code: 49D2016650
  • Facility Name: ADVANCED PEDIATRICS
  • Facility Address: 100 EAST STREET, SE - SUITE 200
    VIENNA, VA
    ZIP 22180
  • Facility Phone: 703 935-8756
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CHRISTINA ULEN
  • NPI Number: 1962686865
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 49D2016650
LAB Type Practitioner Other
Facility Name ADVANCED PEDIATRICS
Street 100 EAST STREET, SE - SUITE 200
City VIENNA
State VA
ZIP 22180
Phone 703 935-8756
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/22/2024
Certificate Expiration Date 11/21/2026
Facility Type Practitioner Other
Lab Director CHRISTINA ULEN

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