49D2062784 CLIA NUMBER - VIRGINIA CANCER SPECIALIST, PC

Laboratory Demographics

  • CLIA Code: 49D2062784
  • Facility Name: VIRGINIA CANCER SPECIALIST, PC
  • Facility Address: 1860 TOWN CENTER DRIVE - SUITE 460
    RESTON, VA
    ZIP 20190
  • Facility Phone: 703 208-3996
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: IVAN AKSENTIJEVICH
  • NPI Number: 1912548470
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2062784
LAB Type Physician Office
Facility Name VIRGINIA CANCER SPECIALIST, PC
Street 1860 TOWN CENTER DRIVE - SUITE 460
City RESTON
State VA
ZIP 20190
Phone 703 208-3996
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Physician Office
Lab Director IVAN AKSENTIJEVICH

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