09D2070414 CLIA NUMBER - MEDICAL SERVICE CENTER, LLC

Laboratory Demographics

  • CLIA Code: 09D2070414
  • Facility Name: MEDICAL SERVICE CENTER, LLC
  • Facility Address: 1160 VARNUM STREET, NE STE 016
    WASHINGTON, DC
    ZIP 20017
  • Facility Phone: 202 526-8622
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ROBERT A. DELAPENHA
  • NPI Number: 1457402711
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 09D2070414
LAB Type Physician Office
Facility Name MEDICAL SERVICE CENTER, LLC
Street 1160 VARNUM STREET, NE STE 016
City WASHINGTON
State DC
ZIP 20017
Phone 202 526-8622
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2023
Certificate Expiration Date 12/15/2025
Facility Type Physician Office
Lab Director DR. ROBERT A. DELAPENHA

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This page was last updated on: 3/20/2025