21D0708002 CLIA NUMBER - PEDIATRIC PARTNERS LLC

Laboratory Demographics

  • CLIA Code: 21D0708002
  • Facility Name: PEDIATRIC PARTNERS LLC
  • Facility Address: 8600 LASALLE RD SUITE 105
    TOWSON, MD
    ZIP 21286
  • Facility Phone: 410 823-5232
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARY JO R. MINTON
  • NPI Number: 1912043936
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D0708002
LAB Type Physician Office
Facility Name PEDIATRIC PARTNERS LLC
Street 8600 LASALLE RD SUITE 105
City TOWSON
State MD
ZIP 21286
Phone 410 823-5232
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2025
Certificate Expiration Date 7/15/2027
Facility Type Physician Office
Lab Director DR. MARY JO R. MINTON

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