49D2191121 CLIA NUMBER - MOSAIC MD, PLLC DBA MOSAIC THEORY MD

Laboratory Demographics

  • CLIA Code: 49D2191121
  • Facility Name: MOSAIC MD, PLLC DBA MOSAIC THEORY MD
  • Facility Address: 22365 BRODERICK DRIVE, SUITE 330
    STERLING, VA
    ZIP 20166
  • Facility Phone: 703 952-7641
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SHERI K. KOCHENDOERFER
  • NPI Number: 1376155648
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D2191121
LAB Type Physician Office
Facility Name MOSAIC MD, PLLC DBA MOSAIC THEORY MD
Street 22365 BRODERICK DRIVE, SUITE 330
City STERLING
State VA
ZIP 20166
Phone 703 952-7641
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/24/2024
Certificate Expiration Date 8/23/2026
Facility Type Physician Office
Lab Director SHERI K. KOCHENDOERFER

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