21D0209482 CLIA NUMBER - VIDYASAGAR ANMANGANDLA MD

Laboratory Demographics

  • CLIA Code: 21D0209482
  • Facility Name: VIDYASAGAR ANMANGANDLA MD
  • Facility Address: 10583 THEODORE GREEN BLVD
    WHITE PLAINS, MD
    ZIP 20695
  • Facility Phone: 301 934-9300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIDYASAGAR ANMANGANDLA
  • NPI Number: 1073589206
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D0209482
LAB Type Physician Office
Facility Name VIDYASAGAR ANMANGANDLA MD
Street 10583 THEODORE GREEN BLVD
City WHITE PLAINS
State MD
ZIP 20695
Phone 301 934-9300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director VIDYASAGAR ANMANGANDLA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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