49D2306740 CLIA NUMBER - NOVA DERMATOLOGY SPECIALISTS

Laboratory Demographics

  • CLIA Code: 49D2306740
  • Facility Name: NOVA DERMATOLOGY SPECIALISTS
  • Facility Address: 8988 LORTON STATIONS BLVD SUITE 103
    LORTON, VA
    ZIP 22079
  • Facility Phone: 703 261-4961
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARINA S. JUNGWIRTH
  • NPI Number: 1447015300
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 49D2306740
LAB Type Physician Office
Facility Name NOVA DERMATOLOGY SPECIALISTS
Street 8988 LORTON STATIONS BLVD SUITE 103
City LORTON
State VA
ZIP 22079
Phone 703 261-4961
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Physician Office
Lab Director MARINA S. JUNGWIRTH

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