21D0214456 CLIA NUMBER - ELLICOTT CITY PEDIATRIC ASSOCIATES PA

Laboratory Demographics

  • CLIA Code: 21D0214456
  • Facility Name: ELLICOTT CITY PEDIATRIC ASSOCIATES PA
  • Facility Address: 9011 CHEVROLET DRIVE STE 1/6
    ELLICOTT CITY, MD
    ZIP 21042
  • Facility Phone: 410 465-7550
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OLIVER GALITA MD
  • NPI Number: 1831152727
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D0214456
LAB Type Physician Office
Facility Name ELLICOTT CITY PEDIATRIC ASSOCIATES PA
Street 9011 CHEVROLET DRIVE STE 1/6
City ELLICOTT CITY
State MD
ZIP 21042
Phone 410 465-7550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2024
Certificate Expiration Date 1/13/2026
Facility Type Physician Office
Lab Director OLIVER GALITA MD

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