21D0220085 CLIA NUMBER - WELLSPRING FAMILY MEDICINE PC

Laboratory Demographics

  • CLIA Code: 21D0220085
  • Facility Name: WELLSPRING FAMILY MEDICINE PC
  • Facility Address: 106 CEMETERY ROAD
    ACCIDENT, MD
    ZIP 21520
  • Facility Phone: 301 334-7855
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARLANA BOLLINGER
  • NPI Number: 1265952998
  • Taxonomy: 103T00000X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 21D0220085
LAB Type Physician Office
Facility Name WELLSPRING FAMILY MEDICINE PC
Street 106 CEMETERY ROAD
City ACCIDENT
State MD
ZIP 21520
Phone 301 334-7855
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type Physician Office
Lab Director DR. MARLANA BOLLINGER

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