49D2286788 CLIA NUMBER - TRINITY FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 49D2286788
  • Facility Name: TRINITY FAMILY PRACTICE
  • Facility Address: 14260R CENTREVILLE SQ
    CENTREVILLE, VA
    ZIP 20121
  • Facility Phone: 571 459-2640
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BLESSY SEBASTIAN
  • NPI Number: 1144955261
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 49D2286788
LAB Type Physician Office
Facility Name TRINITY FAMILY PRACTICE
Street 14260R CENTREVILLE SQ
City CENTREVILLE
State VA
ZIP 20121
Phone 571 459-2640
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2023
Certificate Expiration Date 8/2/2025
Facility Type Physician Office
Lab Director BLESSY SEBASTIAN

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This page was last updated on: 6/4/2025