49D2069993 CLIA NUMBER - ROSELLE CENTER FOR HEALING

Laboratory Demographics

  • CLIA Code: 49D2069993
  • Facility Name: ROSELLE CENTER FOR HEALING
  • Facility Address: 8500 EXECUTIVE PARK AVENUE #300
    FAIRFAX, VA
    ZIP 22031
  • Facility Phone: 703 698-7117
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: R THOMAS ROSELLE
  • NPI Number: 1275729501
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 49D2069993
LAB Type Physician Office
Facility Name ROSELLE CENTER FOR HEALING
Street 8500 EXECUTIVE PARK AVENUE #300
City FAIRFAX
State VA
ZIP 22031
Phone 703 698-7117
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2023
Certificate Expiration Date 12/8/2025
Facility Type Physician Office
Lab Director R THOMAS ROSELLE

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