09D2169285 CLIA NUMBER - HOWARD UNIVERSITY FPP BENNING ROAD

Laboratory Demographics

  • CLIA Code: 09D2169285
  • Facility Name: HOWARD UNIVERSITY FPP BENNING ROAD
  • Facility Address: 4414 BENNING ROAD, NE
    WASHINGTON, DC
    ZIP 20019
  • Facility Phone: 202 865-4132
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TERRANCE FULLUM
  • NPI Number: 1053724963
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 09D2169285
LAB Type Physician Office
Facility Name HOWARD UNIVERSITY FPP BENNING ROAD
Street 4414 BENNING ROAD, NE
City WASHINGTON
State DC
ZIP 20019
Phone 202 865-4132
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/17/2025
Certificate Expiration Date 7/16/2027
Facility Type Physician Office
Lab Director TERRANCE FULLUM

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This page was last updated on: 9/29/2025