21D0970368 CLIA NUMBER - NICK MELLIS MD PA

Laboratory Demographics

  • CLIA Code: 21D0970368
  • Facility Name: NICK MELLIS MD PA
  • Facility Address: 2352 YORK ROAD
    TIMONIUM, MD
    ZIP 21093
  • Facility Phone: 410 560-5652
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: NICK MELLIS MD,PA
  • NPI Number: 1518298389
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D0970368
LAB Type Physician Office
Facility Name NICK MELLIS MD PA
Street 2352 YORK ROAD
City TIMONIUM
State MD
ZIP 21093
Phone 410 560-5652
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/11/2024
Certificate Expiration Date 2/10/2026
Facility Type Physician Office
Lab Director NICK MELLIS MD,PA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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