Fairfax Radiology. 2722 Merrilee Dr. Suite 230. Fairfax, VA 22031. Phone: (703) 698 - 4444. Make a Payment ... Your Payment Data has expired. 1. Patient Information First Name * M.I. Last Name * Patient Account Number * Dates of Service Provided -Statement ID. Statement Date. Email Address. 2. Payment Amount Amount. 3. Payment Method ....