21D0680922 CLIA NUMBER - DUNDALK PEDIATRIC ASSOCIATES PA

Laboratory Demographics

  • CLIA Code: 21D0680922
  • Facility Name: DUNDALK PEDIATRIC ASSOCIATES PA
  • Facility Address: 1792 MERRITT BLVD
    DUNDALK, MD
    ZIP 21222
  • Facility Phone: 410 284-1133
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DIANA FERTSCH MD
  • NPI Number: 1003986704
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D0680922
LAB Type Physician Office
Facility Name DUNDALK PEDIATRIC ASSOCIATES PA
Street 1792 MERRITT BLVD
City DUNDALK
State MD
ZIP 21222
Phone 410 284-1133
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 6/30/2024
Certificate Expiration Date 6/29/2026
Facility Type Physician Office
Lab Director DIANA FERTSCH MD

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