49D2242658 CLIA NUMBER - MMG PRIMARY CARE AT MCLEAN

Laboratory Demographics

  • CLIA Code: 49D2242658
  • Facility Name: MMG PRIMARY CARE AT MCLEAN
  • Facility Address: 1420 BEVERLY RD, SUITE 100
    MCLEAN, VA
    ZIP 22101
  • Facility Phone: 703 852-8287
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASHWINI SARDANA
  • NPI Number: 1255033221
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 49D2242658
LAB Type Physician Office
Facility Name MMG PRIMARY CARE AT MCLEAN
Street 1420 BEVERLY RD, SUITE 100
City MCLEAN
State VA
ZIP 22101
Phone 703 852-8287
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2023
Certificate Expiration Date 11/9/2025
Facility Type Physician Office
Lab Director ASHWINI SARDANA

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