NPIMap

Organization Active NPI

Mid-Atlantic Pathology Services, Inc.

  • Clinical Medical Laboratory
  • McLean, VA
National Provider Identifier
1245302009
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
49D0898222 Issued in VA
Legal business name
MID-ATLANTIC PATHOLOGY SERVICES, INC.
Practice address
1171 Windrock Dr
MC Lean, VA 22102-1547
Phone
(703) 404-8189
Fax
(703) 404-1131
NPI assigned
Nov 15, 2006
Last updated
Apr 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dina Valladares
Title
Senior Director
Phone
(954) 803-9405

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZP0102X
Clinical Medical Laboratory 291U00000X 49D0898222 VA Primary

Addresses

Primary practice location

1171 Windrock Dr
MC Lean, VA 22102-1547

Mailing address

1355 River Bend Dr
Dallas, TX 75247-4915
Phone (214) 638-2000

Other practice location 1

2126 Haycock Rd
Falls Church, VA 22043-1717
Phone (703) 404-8189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20231025003645 DC Part B Supplier - Independent Clinical Laboratory 8729120209 Practice locations: Falls Church, VA; MC Lean, VA
O20240607000434 NC Part B Supplier - Independent Clinical Laboratory 8729120209 Practice locations: Greensboro, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2122918Mid-Atlantic Pathology Services, Falls Church2126 Haycock Road, Falls Church, VA 22043ComplianceMar 21, 2027
49D2178970Mid Atlantic Pathology Services, McLean Satellite1171 Windrock Dr, McLean, VA 22102ComplianceMar 9, 2027

National Provider Directory

National Provider Directory

Locations

405 Glenn Dr
Ste 10A
Sterling, VA 20164
Phone (703) 404-8189

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775520000000",
    "number": "1245302009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 RIVER BEND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474915",
            "telephone_number": "214-638-2000",
            "fax_number": "844-751-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 WINDROCK DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221021547",
            "telephone_number": "703-404-8189",
            "fax_number": "703-404-1131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2126 Haycock Rd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220431717",
            "country_code": "US",
            "telephone_number": "703-404-8189",
            "fax_number": "703-404-1131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MID-ATLANTIC PATHOLOGY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A",
        "authorized_official_last_name": "VALLADARES",
        "authorized_official_first_name": "DINA",
        "authorized_official_title_or_position": "SENIOR DIRECTOR",
        "authorized_official_telephone_number": "954-803-9405"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "VA",
            "license": "49D0898222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McLean, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.