49D2212448 CLIA NUMBER - INTERNAL MEDICINE SERVICES, PLLC

Laboratory Demographics

  • CLIA Code: 49D2212448
  • Facility Name: INTERNAL MEDICINE SERVICES, PLLC
  • Facility Address: 601 KING STREET SUITE 309
    ALEXANDRIA, VA
    ZIP 22314
  • Facility Phone: (704) 709-9362
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM J. MAZZELLA
  • NPI Number: 1508475856
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 49D2212448
LAB Type Physician Office
Facility Name INTERNAL MEDICINE SERVICES, PLLC
Street 601 KING STREET SUITE 309
City ALEXANDRIA
State VA
ZIP 22314
Phone 7047099362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Physician Office
Lab Director WILLIAM J. MAZZELLA

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This page was last updated on: 5/18/2026