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DALEWOOD MEDICAL ENT
NPI 1174549265
Legal Medicine in Dale City, VA

Active since July 14, 2006CLIA 49D2114915 · Waiver
4158 DALE BLVD, DALE CITY, VA 22193(703) 680-5959(703) 730-1046 Get Directions Write a Review

NPPES record last updated: December 27, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dalewood Medical Ent NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DALEWOOD MEDICAL ENT (NPI 1174549265) is a healthcare organization registered as a legal medicine in Dale City, Virginia and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through June 28, 2027 and lists Jennifer Kulak, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1174549265
Entity TypeOrganization
Primary Taxonomy173000000X
Legal Business NameDALEWOOD MEDICAL ENT
Location Address4158 DALE BLVDDale City, VA 22193-2225
Mailing Address4158 Dale BlvdDale City, VA 22193-2225 · (703) 680-5959 · Fax (703) 730-1046
Phone(703) 680-5959
Fax(703) 730-1046
Organization SubpartNo
Authorized OfficialJennifer KulakOffice Manager · (703) 680-5959
Enumeration DateJuly 14, 2006
Last NPPES UpdateDecember 27, 2007
✔ NPI 1174549265 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLegal MedicineOther Service Providers
Taxonomy Code173000000X
Definition
The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.
4158 DALE BLVD, Dale City, VA 22193
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Other Identifiers 1

Medicare PINC02465VA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 49D2114915

Dalewood Medical Center · Woodbridge, VA
Active · expires Jun 28, 2027
CLIA Number49D2114915
Laboratory TypePhysician Office
Certificate Effective DateJune 29, 2025
Certificate Expiration DateJune 28, 2027
Laboratory DirectorNeda Motameni
Laboratory Phone(703) 680-5959
Laboratory LocationDalewood Medical Center4158 Dale Boulevard, Woodbridge, VA 22193
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LJUBICA AZER M.D.
Legal Medicine
4158 DALE BLVD
DALE CITY, VA 22193
Prince William County (703) 680-5959
ALHAJI JALLOH MSN, APRN,FNP-C
Nurse Practitioner (Family)
4158 DALE BLVD
WOODBRIDGE, VA 22193
Prince William County (703) 349-9501
LAUREN MICHELLE MULLER PA-C
Physician Assistant
4158 DALE BLVD
WOODBRIDGE, VA 22193
Prince William County (703) 680-5959
URGE MEDICAL
Clinic/Center (Urgent Care)
4158 DALE BLVD
WOODBRIDGE, VA 22193
Prince William County (703) 680-5959

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dalewood Medical Ent's NPI number?

The NPI number for Dalewood Medical Ent is 1174549265. It was assigned to this organization in the NPPES registry on July 14, 2006.

Where is Dalewood Medical Ent located?

Dalewood Medical Ent is located at 4158 Dale Blvd, Dale City, VA 22193. The listed phone number is (703) 680-5959.

What is Dalewood Medical Ent's specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

Does Dalewood Medical Ent hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D2114915) is associated with this NPI, valid through June 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Dalewood Medical Ent was last updated on December 27, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.