21D0663504 CLIA NUMBER - CONCENTRA - GAITHERSBURG

Laboratory Demographics

  • CLIA Code: 21D0663504
  • Facility Name: CONCENTRA - GAITHERSBURG
  • Facility Address: 733 S FREDERICK AVENUE
    GAITHERSBURG, MD
    ZIP 20877
  • Facility Phone: 301 869-0700
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: MARTIN LISS MD
  • NPI Number: 1164971461
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D0663504
LAB Type Community Clinic
Facility Name CONCENTRA - GAITHERSBURG
Street 733 S FREDERICK AVENUE
City GAITHERSBURG
State MD
ZIP 20877
Phone 301 869-0700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/19/2025
Certificate Expiration Date 8/18/2027
Facility Type Community Clinic
Lab Director MARTIN LISS MD

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