21D0696354 CLIA NUMBER - SUSAN JENKINS MD PA

Laboratory Demographics

  • CLIA Code: 21D0696354
  • Facility Name: SUSAN JENKINS MD PA
  • Facility Address: 1450 MERCANTILE LANE SUTTE 117
    LARGO, MD
    ZIP 20774
  • Facility Phone: 301 249-0060
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: SUSAN E. JENKINS
  • NPI Number: 1942299417
  • Taxonomy: 207VG0400X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 21D0696354
LAB Type Physician Office
Facility Name SUSAN JENKINS MD PA
Street 1450 MERCANTILE LANE SUTTE 117
City LARGO
State MD
ZIP 20774
Phone 301 249-0060
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director SUSAN E. JENKINS

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