49D2192019 CLIA NUMBER - KELIZ HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 49D2192019
  • Facility Name: KELIZ HEALTH SERVICES
  • Facility Address: 85 S BRAGG STREET #401
    ALEXANDRIA, VA
    ZIP 22312
  • Facility Phone: 703 814-5106
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: OCTAVIE B. BONGAM-SIKOD
  • NPI Number: 1063977403
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 49D2192019
LAB Type Home Health Agency
Facility Name KELIZ HEALTH SERVICES
Street 85 S BRAGG STREET #401
City ALEXANDRIA
State VA
ZIP 22312
Phone 703 814-5106
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2024
Certificate Expiration Date 9/2/2026
Facility Type Home Health Agency
Lab Director OCTAVIE B. BONGAM-SIKOD

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