49D2308074 CLIA NUMBER - DISTINCTIVE DERMATOLOGY PLLC

Laboratory Demographics

  • CLIA Code: 49D2308074
  • Facility Name: DISTINCTIVE DERMATOLOGY PLLC
  • Facility Address: 8603 WESTWOOD CENTER DRIVE, SUITE 320
    VIENNA, VA
    ZIP 22182
  • Facility Phone: 703 570-1192
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: AMBER R. ATWATER
  • NPI Number: 1386481109
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 49D2308074
LAB Type Physician Office
Facility Name DISTINCTIVE DERMATOLOGY PLLC
Street 8603 WESTWOOD CENTER DRIVE, SUITE 320
City VIENNA
State VA
ZIP 22182
Phone 703 570-1192
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 7/22/2024
Certificate Expiration Date 7/21/2026
Facility Type Physician Office
Lab Director AMBER R. ATWATER

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