CHANTILLY WALK-IN CLINIC
NPI 1972509735
Clinic/Center in Fairfax, VA

NPI Status: Active since June 24, 2005

Contact Information

13037 LEE JACKSON HWY
STE D
FAIRFAX, VA
ZIP 22033
Phone: (703) 631-0791
Fax: (703) 968-4227

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  • Organization
  • Clinic/Center
  • CLIA Number: 49D0860180
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 08-31-2026

About CHANTILLY WALK-IN CLINIC

This page provides the complete NPI Profile along with additional information for Chantilly Walk-in Clinic, a provider established in Fairfax, Virginia operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1972509735 assigned on June 2005. The practitioner's primary taxonomy code is 261Q00000X with license number 0101036326 (VA). The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Dr. Samir Nazam M.d. (Physician)

NPI
1972509735
Provider Name
CHANTILLY WALK-IN CLINIC
Entity Type
Organization
Location Address
13037 LEE JACKSON HWY STE D FAIRFAX, VA 22033
Location Phone
(703) 631-0791
Location Fax
(703) 968-4227
Mailing Address
PO BOX 221226 CHANTILLY, VA 20153
Mailing Phone
(703) 631-0791
Mailing Fax
(703) 968-4227
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-24-2005
Last Update Date
08-22-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center

Taxonomy Code
261Q00000X
Type
Ambulatory Health Care Facilities
License No.
0101036326
License State
VA
Taxonomy Description
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. SAMIR NAZAM M.D.

Authorized Official Title
PHYSICIAN
Authorized Official Phone
(703) 631-0791

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
292549OTHER (01)VAB/C PROVIDER #

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
49D0860180
Facility Type
Physician Office
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
SAMIR NAZAM
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Chantilly Walk-in Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1972509735
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
291421001876
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 1 + 4 + 2 + 1 + 0 + 0 + 1 + 8 + 7 + 6 + 24 = 65
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 65 = 55

The NPI number 1972509735 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1972509735, enumerated in the NPI registry as an "organization" on June 24, 2005

The provider is located at 13037 Lee Jackson Hwy Ste D Fairfax, Va 22033 and the phone number is (703) 631-0791

This medical organization specializes in Clinic/Center with taxonomy code 261Q00000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 49D0860180 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on June 24, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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