21D0997965 CLIA NUMBER - RUSSELL O SCHUB PA

Laboratory Demographics

  • CLIA Code: 21D0997965
  • Facility Name: RUSSELL O SCHUB PA
  • Facility Address: 8875 CENTRE PARK DRIVE STE D
    COLUMBIA, MD
    ZIP 21045
  • Facility Phone: 410 730-1000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RUSSELL O. SCHUB
  • NPI Number: 1679583587
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D0997965
LAB Type Physician Office
Facility Name RUSSELL O SCHUB PA
Street 8875 CENTRE PARK DRIVE STE D
City COLUMBIA
State MD
ZIP 21045
Phone 410 730-1000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2024
Certificate Expiration Date 4/1/2026
Facility Type Physician Office
Lab Director RUSSELL O. SCHUB

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