49D2122154 CLIA NUMBER - LIFETIME INTERNAL MEDICINE, PLLC

Laboratory Demographics

  • CLIA Code: 49D2122154
  • Facility Name: LIFETIME INTERNAL MEDICINE, PLLC
  • Facility Address: 2579 JOHN MILTON DRIVE - SUITE 300
    HERNDON, VA
    ZIP 20171
  • Facility Phone: (703) 828-0799
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHALINI KANERIYA
  • NPI Number: 1346715141
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D2122154
LAB Type Physician Office
Facility Name LIFETIME INTERNAL MEDICINE, PLLC
Street 2579 JOHN MILTON DRIVE - SUITE 300
City HERNDON
State VA
ZIP 20171
Phone 7038280799
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/21/2024
Certificate Expiration Date 11/20/2026
Facility Type Physician Office
Lab Director SHALINI KANERIYA

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This page was last updated on: 5/18/2026