21D0221005 CLIA NUMBER - FREDERICK PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 21D0221005
  • Facility Name: FREDERICK PRIMARY CARE
  • Facility Address: 10200 COPPERMINE ROAD
    WOODSBORO, MD
    ZIP 21798
  • Facility Phone: 301 845-6322
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: GENE F. ASHE MD
  • NPI Number: 1811724099
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D0221005
LAB Type Physician Office
Facility Name FREDERICK PRIMARY CARE
Street 10200 COPPERMINE ROAD
City WOODSBORO
State MD
ZIP 21798
Phone 301 845-6322
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/26/2024
Certificate Expiration Date 2/25/2026
Facility Type Physician Office
Lab Director GENE F. ASHE MD

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