49D2209582 CLIA NUMBER - MATTHEW HADEN MD, PLLC DBA MODERN MOBILE MEDICINE

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Laboratory Demographics

CLIA Number: 49D2209582

Facility Name: MATTHEW HADEN MD, PLLC DBA MODERN MOBILE MEDICINE

Facility Address:
2201 MT VERNON AVE SUITE 105
ALEXANDRIA, VA
ZIP 22301
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Facility Phone Number: 888 765-1444

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1851426092

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	49D2209582
LAB Type	Physician Office
Facility Name	MATTHEW HADEN MD, PLLC DBA MODERN MOBILE MEDICINE
Street	2201 MT VERNON AVE SUITE 105
City	ALEXANDRIA
State	VA
ZIP	22301
Phone	888 765-1444
CertificateType	4
CertificateEffectiveDate	1/14/2023
CertificateExpirationDate	1/13/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024