Northern Virginia Laboratory

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

NORTHERN VIRGINIA LABORATORY

Practice address

4660 Kenmore Ave
Alexandria, VA 22304-1313

Phone

(703) 207-7072

Fax

(703) 207-7074

NPI assigned

Mar 20, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Sandra B Maddux

Title

Owner/Manager

Phone

(703) 207-7072

Specialties & licenses 1

Addresses

Other names 1

• Northern Virginia Laboratory LLC Other name

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

CLIA laboratory certificates

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1659812832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8422 GIRVAN CT",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "20109",
            "telephone_number": "703-207-7072",
            "fax_number": "703-207-7074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-207-7072",
            "fax_number": "703-207-7074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN VIRGINIA LABORATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "MADDUX",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "703-207-7072",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Virginia Laboratory LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Medical Laboratory in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Clinical Medical Laboratory in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.