49D2199435 CLIA NUMBER - VAN DORN PHARMACY

Laboratory Demographics

  • CLIA Code: 49D2199435
  • Facility Name: VAN DORN PHARMACY
  • Facility Address: 5724 EDSALL RD
    ALEXANDRIA, VA
    ZIP 22304
  • Facility Phone: 703 348-7186
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: YODIT GULELAT
  • NPI Number: 1174151716
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 49D2199435
LAB Type Pharmacy
Facility Name VAN DORN PHARMACY
Street 5724 EDSALL RD
City ALEXANDRIA
State VA
ZIP 22304
Phone 703 348-7186
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Pharmacy
Lab Director YODIT GULELAT

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