# INOVA RESTON MRI CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FAIRFAX PET CT IMAGING CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952636581
- **Authorized official:** ALICE POPE (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (703) 289-2048

## Contact information

- **Practice address:** 8081 INNOVATION PARK DR STE 204, FAIRFAX, VA 22031-4867
- **Practice address phone:** (703) 698-9600
- **Practice address fax:** (703) 698-5930
- **Mailing address:** 2722 MERRILEE DR STE 230, FAIRFAX, VA 22031-4400
- **Mailing address phone:** (703) 698-4444
- **Mailing address fax:** (703) 204-0116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/15/2009
- **Last updated:** 11/02/2022