21D0958711 CLIA NUMBER - MIKHAIL GENDEL FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 21D0958711
  • Facility Name: MIKHAIL GENDEL FAMILY PRACTICE LLC
  • Facility Address: 16220 FREDERICK ROAD STE 200
    GAITHERSBURG, MD
    ZIP 20877
  • Facility Phone: 301 519-2650
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MIKHAIL GENDEL MD
  • NPI Number: 1235178344
  • Taxonomy: 207QA0505X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D0958711
LAB Type Physician Office
Facility Name MIKHAIL GENDEL FAMILY PRACTICE LLC
Street 16220 FREDERICK ROAD STE 200
City GAITHERSBURG
State MD
ZIP 20877
Phone 301 519-2650
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Physician Office
Lab Director MIKHAIL GENDEL MD

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