21D0932361 CLIA NUMBER - VINU GANTI MD PC

Laboratory Demographics

  • CLIA Code: 21D0932361
  • Facility Name: VINU GANTI MD PC
  • Facility Address: 12800 MIDDLEBROOK ROAD SUITE #204
    GERMANTOWN, MD
    ZIP 20874
  • Facility Phone: 301 540-8146
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: VINU GANTI MD
  • NPI Number: 1760499826
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D0932361
LAB Type Practitioner Other
Facility Name VINU GANTI MD PC
Street 12800 MIDDLEBROOK ROAD SUITE #204
City GERMANTOWN
State MD
ZIP 20874
Phone 301 540-8146
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2024
Certificate Expiration Date 10/19/2026
Facility Type Practitioner Other
Lab Director VINU GANTI MD

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