21D0212216 CLIA NUMBER - MONTGOMERY HEALTH CENTER, LLC

Laboratory Demographics

CLIA Number: 21D0212216

Facility Name: MONTGOMERY HEALTH CENTER, LLC

Facility Address:
14800 PHYSICIANS LN #131
ROCKVILLE, MD
ZIP 20850
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Facility Phone Number: 301 251-9800

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1982059564

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D0212216
LAB Type	Physician Office
Facility Name	MONTGOMERY HEALTH CENTER, LLC
Street	14800 PHYSICIANS LN #131
City	ROCKVILLE
State	MD
ZIP	20850
Phone	301 251-9800
CertificateType	4
CertificateEffectiveDate	2/8/2024
CertificateExpirationDate	2/7/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024