Provider Demographics
NPI:1528494994
Name:VIRGINIA MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:VIRGINIA MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEIFU
Authorized Official - Middle Name:
Authorized Official - Last Name:SERTSE
Authorized Official - Suffix:
Authorized Official - Credentials:MT(ASCP), MBA
Authorized Official - Phone:703-436-1626
Mailing Address - Street 1:25272 RIFFLEFORD SQ
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-5351
Mailing Address - Country:US
Mailing Address - Phone:703-434-9879
Mailing Address - Fax:866-931-1324
Practice Address - Street 1:3534 CARLIN SPRINGS RD
Practice Address - Street 2:SUITE 5
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-3000
Practice Address - Country:US
Practice Address - Phone:703-436-1626
Practice Address - Fax:866-931-1324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA202857291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory