49D2104153 CLIA NUMBER - LOUDOUN MEDICAL GROUP LABORATORY

Laboratory Demographics

  • CLIA Code: 49D2104153
  • Facility Name: LOUDOUN MEDICAL GROUP LABORATORY
  • Facility Address: 19450 DEERFIELD AVENUE - SUITE 375
    LEESBURG, VA
    ZIP 20176
  • Facility Phone: 571 789-1846
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: RICHARD Y. KIM
  • NPI Number: 1043676182
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 49D2104153
LAB Type Physician Office
Facility Name LOUDOUN MEDICAL GROUP LABORATORY
Street 19450 DEERFIELD AVENUE - SUITE 375
City LEESBURG
State VA
ZIP 20176
Phone 571 789-1846
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 5/11/2024
Certificate Expiration Date 5/10/2026
Facility Type Physician Office
Lab Director RICHARD Y. KIM

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