49D2134571 CLIA NUMBER - MARY WASHINGTON HEALTHCARE-WELLNESS PROGRAM

Laboratory Demographics

  • CLIA Code: 49D2134571
  • Facility Name: MARY WASHINGTON HEALTHCARE-WELLNESS PROGRAM
  • Facility Address: 1101 SAM PERRY BOULEVARD - SUITE 304
    FREDERICKSBURG, VA
    ZIP 22401
  • Facility Phone: 540 374-3279
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JESSICA BEDWELL
  • NPI Number: 1306405709
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 49D2134571
LAB Type Physician Office
Facility Name MARY WASHINGTON HEALTHCARE-WELLNESS PROGRAM
Street 1101 SAM PERRY BOULEVARD - SUITE 304
City FREDERICKSBURG
State VA
ZIP 22401
Phone 540 374-3279
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2025
Certificate Expiration Date 8/3/2027
Facility Type Physician Office
Lab Director JESSICA BEDWELL

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