21D1000313 CLIA NUMBER - MICHAEL A RANDOLPH MD PC

Laboratory Demographics

  • CLIA Code: 21D1000313
  • Facility Name: MICHAEL A RANDOLPH MD PC
  • Facility Address: 200 33RD STREET STE 136
    BALTIMORE, MD
    ZIP 21218
  • Facility Phone: 410 554-6489
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. MICHAEL A. RANDOLPH
  • NPI Number: 1215095203
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D1000313
LAB Type Physician Office
Facility Name MICHAEL A RANDOLPH MD PC
Street 200 33RD STREET STE 136
City BALTIMORE
State MD
ZIP 21218
Phone 410 554-6489
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 6/7/2024
Certificate Expiration Date 6/6/2026
Facility Type Physician Office
Lab Director DR. MICHAEL A. RANDOLPH

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