Al J. Facca, 49, associate director of the American Medical Association's federal affairs department here since 1976 who was a Public Health Service official from 1969 to 1973, died Saturday at Fairfax Hospital after a heart attack. He lived in Annandale.

Mr. Facca began his career with the Public Health Service's Health Services and Mental Health Administration in Rockville. During his last year with the Service, he was chief of the office of Ambulatory Health Care Standards.

He joined the AMA in 1973 as deputy director of its Management Services Division in Chicago, then returned here three years later. From 1961 to 1967, he had been a salesman for several chemical firms in New York and California, and a sales manager with Wyeth Laboratories in Los Angeles.

He also had worked for the Philadelphia public health department in the late 1950s and been a consultant to the Bay Area Social Planning Council in Oakland in the late 1960s.

Mr. Facca was a member of the American Public Health Association and the American Association of Medical Society Executives.

He attended Holy Spirit Catholic Church and St. Ambrose Catholic Church, both in Annandale.

Mr. Facca was a native of New York City and served in the Army in the mid-1950s. He earned a bachelor's degree in public health at Indiana University and a master's degree in health-medical care administration at the University of California at Los Angeles.

His marriage to Maxine Facca ended in divorce.

Mr. Facca's survivors include a son, Thomas, and a daughter, Amy Facca, both of Annandale; his parents, Mr. and Mrs. Guido Facca, and a sister, Diane Maddaleno, all of New York City.