21D0898845 CLIA NUMBER - MDS PEDIATRICS LLC

Laboratory Demographics

CLIA Number: 21D0898845

Facility Name: MDS PEDIATRICS LLC

Facility Address:
9701 NEW CHURCH STREET SUITE B
DAMASCUS, MD
ZIP 20872
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Facility Phone Number: 301 414-0023

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1699299107

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	21D0898845
LAB Type	Physician Office
Facility Name	MDS PEDIATRICS LLC
Street	9701 NEW CHURCH STREET SUITE B
City	DAMASCUS
State	MD
ZIP	20872
Phone	301 414-0023
CertificateType	4
CertificateEffectiveDate	10/24/2022
CertificateExpirationDate	10/23/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024