49D2071290 CLIA NUMBER - PREMISE HEALTH OF VIRGINIA MEDICAL PC

Laboratory Demographics

  • CLIA Code: 49D2071290
  • Facility Name: PREMISE HEALTH OF VIRGINIA MEDICAL PC
  • Facility Address: 190 SECURITY DRIVE
    WINCHESTER, VA
    ZIP 22602
  • Facility Phone: 877 222-8808
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOHAMMED AL-KADIRI
  • NPI Number: 1164055216
  • Taxonomy: 261QP2000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D2071290
LAB Type Physician Office
Facility Name PREMISE HEALTH OF VIRGINIA MEDICAL PC
Street 190 SECURITY DRIVE
City WINCHESTER
State VA
ZIP 22602
Phone 877 222-8808
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2024
Certificate Expiration Date 1/7/2026
Facility Type Physician Office
Lab Director MOHAMMED AL-KADIRI

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