49D2103685 CLIA NUMBER - MARYAM MAHMOODIAN, MD FAMILY MEDICINE LLC

Laboratory Demographics

CLIA Number: 49D2103685

Facility Name: MARYAM MAHMOODIAN, MD FAMILY MEDICINE LLC

Facility Address:
2015 RESERVOIR STREET, SUITE 203
HARRISONBURG, VA
ZIP 22801
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Facility Phone Number: 540 209-0287

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1508213877

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	49D2103685
LAB Type	Physician Office
Facility Name	MARYAM MAHMOODIAN, MD FAMILY MEDICINE LLC
Street	2015 RESERVOIR STREET, SUITE 203
City	HARRISONBURG
State	VA
ZIP	22801
Phone	540 209-0287
CertificateType	4
CertificateEffectiveDate	10/19/2023
CertificateExpirationDate	10/18/2025
FacilityType	Waiver

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