49D2278906 CLIA NUMBER - MARY WASHINGTON INTERNAL MEDICINE RESIDENCY CLINIC

Laboratory Demographics

  • CLIA Code: 49D2278906
  • Facility Name: MARY WASHINGTON INTERNAL MEDICINE RESIDENCY CLINIC
  • Facility Address: 1201 SAM PERRY BOULEVARD, SUITE 201
    FREDERICKSBURG, VA
    ZIP 22401
  • Facility Phone: 540 741-9200
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANNE W. WAGSTAFF

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CLIA Record

Field Name Field Value
CLIA Number 49D2278906
LAB Type Physician Office
Facility Name MARY WASHINGTON INTERNAL MEDICINE RESIDENCY CLINIC
Street 1201 SAM PERRY BOULEVARD, SUITE 201
City FREDERICKSBURG
State VA
ZIP 22401
Phone 540 741-9200
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 3/27/2025
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director ANNE W. WAGSTAFF

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This page was last updated on: 3/20/2025