49D2119881 CLIA NUMBER - RESTON ENDOSCOPY CENTER

Laboratory Demographics

  • CLIA Code: 49D2119881
  • Facility Name: RESTON ENDOSCOPY CENTER
  • Facility Address: 1939 ROLAND PARK PLACE #200
    RESTON, VA
    ZIP 20191
  • Facility Phone: (703) 766-2650
  • Facility Type: Other - ENDOSCOPY CENTER
  • Facility Type: Waiver
  • Lab Director: ANDREW M. AXELRAD
  • NPI Number: 1720535958
  • Taxonomy: 261QE0800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D2119881
LAB Type Other - ENDOSCOPY CENTER
Facility Name RESTON ENDOSCOPY CENTER
Street 1939 ROLAND PARK PLACE #200
City RESTON
State VA
ZIP 20191
Phone 7037662650
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2024
Certificate Expiration Date 10/4/2026
Facility Type Other - ENDOSCOPY CENTER
Lab Director ANDREW M. AXELRAD

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This page was last updated on: 5/15/2026