Organization
CLINICAL DIAGNOSTIC LABORATORIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IBTIHAJ AWADELKARIEM (CEO/TECHNICAL DIRECTOR)
(703) 430-1111
Entity
Organization
Contact information
Practice address
44355 PREMIER PLZ STE 240, ASHBURN, VA 20147-5050
(703) 430-1111
(703) 722-3890
Mailing address
44355 PREMIER PLZ STE 240, ASHBURN, VA 20147-5050
(703) 430-1111
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881101475
—
VA
Enumeration date
01/04/2018
Last updated
01/08/2025
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