49D2086276 CLIA NUMBER - KENNETH J KIM, MD, PC

Laboratory Demographics

  • CLIA Code: 49D2086276
  • Facility Name: KENNETH J KIM, MD, PC
  • Facility Address: 3930 PENDER DR - SUITE 330
    FAIRFAX, VA
    ZIP 22030
  • Facility Phone: 703 246-0022
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENNETH J. KIM
  • NPI Number: 1124221924
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 49D2086276
LAB Type Physician Office
Facility Name KENNETH J KIM, MD, PC
Street 3930 PENDER DR - SUITE 330
City FAIRFAX
State VA
ZIP 22030
Phone 703 246-0022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2024
Certificate Expiration Date 10/29/2026
Facility Type Physician Office
Lab Director KENNETH J. KIM

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