49D2163822 CLIA NUMBER - TRINITY HOME CARE SERVICES LLC

Laboratory Demographics

  • CLIA Code: 49D2163822
  • Facility Name: TRINITY HOME CARE SERVICES LLC
  • Facility Address: 3102 GOLANSKY BLVD SUITE 201
    WOODBRIDGE, VA
    ZIP 22192
  • Facility Phone: 571 398-6736
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: CHIKATA KHYNE-SAM
  • NPI Number: 1073182762
  • Taxonomy: 103K00000X - Behavior Analyst

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CLIA Record

Field Name Field Value
CLIA Number 49D2163822
LAB Type Home Health Agency
Facility Name TRINITY HOME CARE SERVICES LLC
Street 3102 GOLANSKY BLVD SUITE 201
City WOODBRIDGE
State VA
ZIP 22192
Phone 571 398-6736
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2025
Certificate Expiration Date 3/20/2027
Facility Type Home Health Agency
Lab Director CHIKATA KHYNE-SAM

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This page was last updated on: 3/20/2025