Organization
FAIRFAX MEDICAL LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASRA RAHMAN CEO (OWNER)
(571) 577-5556
Entity
Organization
Contact information
Practice address
4221 WALNEY RD STE 401A, CHANTILLY, VA 20151-2987
(571) 577-5556
Mailing address
4221 WALNEY RD STE 401A, CHANTILLY, VA 20151-2987
(571) 577-5556
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
07/24/2020
Last updated
09/09/2020
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