49D2156352 CLIA NUMBER - CLEMENTINE TWIN LAKES

Laboratory Demographics

  • CLIA Code: 49D2156352
  • Facility Name: CLEMENTINE TWIN LAKES
  • Facility Address: 13215 TWIN LAKES DRIVE
    CLIFTON, VA
    ZIP 20124
  • Facility Phone: 571 281-0254
  • Facility Type: Other - RESIDENTIAL TREAT FAC
  • Facility Type: Waiver
  • Lab Director: JOEL JAHRAUS
  • NPI Number: 1801375118
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 49D2156352
LAB Type Other - RESIDENTIAL TREAT FAC
Facility Name CLEMENTINE TWIN LAKES
Street 13215 TWIN LAKES DRIVE
City CLIFTON
State VA
ZIP 20124
Phone 571 281-0254
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2024
Certificate Expiration Date 10/15/2026
Facility Type Other - RESIDENTIAL TREAT FAC
Lab Director JOEL JAHRAUS

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