21D0671593 CLIA NUMBER - PATUXENT RIVER HEALTH & REHAB

Laboratory Demographics

  • CLIA Code: 21D0671593
  • Facility Name: PATUXENT RIVER HEALTH & REHAB
  • Facility Address: 14200 LAUREL PARK DRIVE
    LAUREL, MD
    ZIP 20707
  • Facility Phone: 410 792-4717
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: MITUL DAVE MD
  • NPI Number: 1407977085
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 21D0671593
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PATUXENT RIVER HEALTH & REHAB
Street 14200 LAUREL PARK DRIVE
City LAUREL
State MD
ZIP 20707
Phone 410 792-4717
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/9/2024
Certificate Expiration Date 8/8/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director MITUL DAVE MD

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