49D2082478 CLIA NUMBER - BNM, INC DBA MY KID'S PEDIATRICS AND ADOLESCENT CARE

Laboratory Demographics

  • CLIA Code: 49D2082478
  • Facility Name: BNM, INC DBA MY KID'S PEDIATRICS AND ADOLESCENT CARE
  • Facility Address: 12011 LEE JACKSON MEMORIAL HIGHWAY, SUITE 220
    FAIRFAX, VA
    ZIP 22033
  • Facility Phone: 703 865-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRISTINA S. JUNG
  • NPI Number: 1033535778
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 49D2082478
LAB Type Physician Office
Facility Name BNM, INC DBA MY KID'S PEDIATRICS AND ADOLESCENT CARE
Street 12011 LEE JACKSON MEMORIAL HIGHWAY, SUITE 220
City FAIRFAX
State VA
ZIP 22033
Phone 703 865-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2024
Certificate Expiration Date 8/14/2026
Facility Type Physician Office
Lab Director CHRISTINA S. JUNG

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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