49D2184167 CLIA NUMBER - KC PHARMACY HEALTH MART, INC

Laboratory Demographics

  • CLIA Code: 49D2184167
  • Facility Name: KC PHARMACY HEALTH MART, INC
  • Facility Address: 8988 LORTON STATION BLVD
    LORTON, VA
    ZIP 22079
  • Facility Phone: (703) 339-9599
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GIHAN SERAKA
  • NPI Number: 1093081028
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2184167
LAB Type Pharmacy
Facility Name KC PHARMACY HEALTH MART, INC
Street 8988 LORTON STATION BLVD
City LORTON
State VA
ZIP 22079
Phone 7033399599
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2026
Certificate Expiration Date 5/14/2028
Facility Type Pharmacy
Lab Director GIHAN SERAKA

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