21D0211605 CLIA NUMBER - MEDSTAR HEALTH UROLOGY AT CHEVY CHASE

Laboratory Demographics

  • CLIA Code: 21D0211605
  • Facility Name: MEDSTAR HEALTH UROLOGY AT CHEVY CHASE
  • Facility Address: 5530 WISCONSIN AVE 950
    CHEVY CHASE, MD
    ZIP 20815
  • Facility Phone: 301 535-6501
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEITH KOWALCZYK
  • NPI Number: 1184863821
  • Taxonomy: 3336C0003X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D0211605
LAB Type Physician Office
Facility Name MEDSTAR HEALTH UROLOGY AT CHEVY CHASE
Street 5530 WISCONSIN AVE 950
City CHEVY CHASE
State MD
ZIP 20815
Phone 301 535-6501
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2025
Certificate Expiration Date 2/14/2027
Facility Type Physician Office
Lab Director KEITH KOWALCZYK

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