21D0951392 CLIA NUMBER - IMELDA R MIRANDA MD

Laboratory Demographics

  • CLIA Code: 21D0951392
  • Facility Name: IMELDA R MIRANDA MD
  • Facility Address: 7611 S OSBORNE ROAD STE 106
    UPPER MARLBORO, MD
    ZIP 20772
  • Facility Phone: 301 599-8584
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IMELDA R. MIRANDA MD
  • NPI Number: 1578510681
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D0951392
LAB Type Physician Office
Facility Name IMELDA R MIRANDA MD
Street 7611 S OSBORNE ROAD STE 106
City UPPER MARLBORO
State MD
ZIP 20772
Phone 301 599-8584
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Physician Office
Lab Director IMELDA R. MIRANDA MD

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