21D0211975 CLIA NUMBER - RCCA MD LLC- CHOP

Laboratory Demographics

  • CLIA Code: 21D0211975
  • Facility Name: RCCA MD LLC- CHOP
  • Facility Address: 18111 PRINCE PHILLIPS DRIVE, SUITE 327
    OLNEY, MD
    ZIP 20832
  • Facility Phone: 301 774-6136
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: PAUL A. BANNEN
  • NPI Number: 1366009938
  • Taxonomy: 207RH0003X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D0211975
LAB Type Physician Office
Facility Name RCCA MD LLC- CHOP
Street 18111 PRINCE PHILLIPS DRIVE, SUITE 327
City OLNEY
State MD
ZIP 20832
Phone 301 774-6136
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 11/25/2024
Certificate Expiration Date 11/24/2026
Facility Type Physician Office
Lab Director PAUL A. BANNEN

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