49D2078672 CLIA NUMBER - PATIENT FIRST - CHANTILLY

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Laboratory Demographics

CLIA Number: 49D2078672

Facility Name: PATIENT FIRST - CHANTILLY

Facility Address:
3918 CENTREVILLE ROAD
CHANTILLY, VA
ZIP 20151
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Facility Phone Number: 703 657-6925

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1871908145

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	49D2078672
LAB Type	Physician Office
Facility Name	PATIENT FIRST - CHANTILLY
Street	3918 CENTREVILLE ROAD
City	CHANTILLY
State	VA
ZIP	20151
Phone	703 657-6925
CertificateType	2
CertificateEffectiveDate	11/5/2022
CertificateExpirationDate	11/4/2024
FacilityType	Compliance

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This page was last updated on: 4/23/2024