21D0689728 CLIA NUMBER - CALVERT INTERNAL MEDICINE GROUP

Laboratory Demographics

  • CLIA Code: 21D0689728
  • Facility Name: CALVERT INTERNAL MEDICINE GROUP
  • Facility Address: 985 PRINCE FREDERICK BOULEVARD SUITE 201
    PRINCE FREDERICK, MD
    ZIP 20678
  • Facility Phone: 410 535-2005
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. PAUL POMILLA
  • NPI Number: 1174682298
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D0689728
LAB Type Physician Office
Facility Name CALVERT INTERNAL MEDICINE GROUP
Street 985 PRINCE FREDERICK BOULEVARD SUITE 201
City PRINCE FREDERICK
State MD
ZIP 20678
Phone 410 535-2005
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 5/19/2024
Certificate Expiration Date 5/18/2026
Facility Type Physician Office
Lab Director DR. PAUL POMILLA

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