09D2018348 CLIA NUMBER - MCCLENDON CENTER

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Laboratory Demographics

CLIA Number: 09D2018348

Facility Name: MCCLENDON CENTER

Facility Address:
1338 NORTH CAPITOL ST, NW
WASHINGTON, DC
ZIP 20002
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Facility Phone Number: 202 745-0073

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1396778361

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	09D2018348
LAB Type	Physician Office
Facility Name	MCCLENDON CENTER
Street	1338 NORTH CAPITOL ST, NW
City	WASHINGTON
State	DC
ZIP	20002
Phone	202 745-0073
CertificateType	4
CertificateEffectiveDate	1/3/2023
CertificateExpirationDate	1/2/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024