49D2197182 CLIA NUMBER - PAUL B CANNON DPM PC

Laboratory Demographics

  • CLIA Code: 49D2197182
  • Facility Name: PAUL B CANNON DPM PC
  • Facility Address: 104A EAST BROAD STREET
    FALLS CHURCH, VA
    ZIP 22046
  • Facility Phone: 703 237-1555
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: PAUL B. CANNON
  • NPI Number: 1740285022
  • Taxonomy: 213ES0103X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 49D2197182
LAB Type Physician Office
Facility Name PAUL B CANNON DPM PC
Street 104A EAST BROAD STREET
City FALLS CHURCH
State VA
ZIP 22046
Phone 703 237-1555
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 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Physician Office
Lab Director PAUL B. CANNON

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