21D0898447 CLIA NUMBER - CARROLL HEALTH GRP FAMILY MEDICAL ASSOCIATES, LLC

Laboratory Demographics

  • CLIA Code: 21D0898447
  • Facility Name: CARROLL HEALTH GRP FAMILY MEDICAL ASSOCIATES, LLC
  • Facility Address: 444 WMC DRIVE STE 100
    WESTMINSTER, MD
    ZIP 21158
  • Facility Phone: 410 861-8960
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ERNESTO M. MENDOZA
  • NPI Number: 1235294489
  • Taxonomy: 208C00000X - Colon & Rectal Surgery

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CLIA Record

Field Name Field Value
CLIA Number 21D0898447
LAB Type Physician Office
Facility Name CARROLL HEALTH GRP FAMILY MEDICAL ASSOCIATES, LLC
Street 444 WMC DRIVE STE 100
City WESTMINSTER
State MD
ZIP 21158
Phone 410 861-8960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Physician Office
Lab Director DR. ERNESTO M. MENDOZA

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