21D0897337 CLIA NUMBER - SUNRISE AT MONTGOMERY VILLAGE

Laboratory Demographics

  • CLIA Code: 21D0897337
  • Facility Name: SUNRISE AT MONTGOMERY VILLAGE
  • Facility Address: 19310 CLUB HOUSE ROAD
    MONTGOMERY VILLAGE, MD
    ZIP 20886
  • Facility Phone: 301 921-0445
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: RAMANI NOKKU
  • NPI Number: 1407691041
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 21D0897337
LAB Type Assisted Living Facility
Facility Name SUNRISE AT MONTGOMERY VILLAGE
Street 19310 CLUB HOUSE ROAD
City MONTGOMERY VILLAGE
State MD
ZIP 20886
Phone 301 921-0445
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2025
Certificate Expiration Date 5/6/2027
Facility Type Assisted Living Facility
Lab Director RAMANI NOKKU

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