21D1000781 CLIA NUMBER - GHOUSIA SULTANA

Laboratory Demographics

  • CLIA Code: 21D1000781
  • Facility Name: GHOUSIA SULTANA
  • Facility Address: 12107 HERITAGE PARK CIRCLE
    SILVER SPRING, MD
    ZIP 20906
  • Facility Phone: 301 949-7000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GHOUSIA SULTANA
  • NPI Number: 1346294279
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D1000781
LAB Type Physician Office
Facility Name GHOUSIA SULTANA
Street 12107 HERITAGE PARK CIRCLE
City SILVER SPRING
State MD
ZIP 20906
Phone 301 949-7000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Physician Office
Lab Director GHOUSIA SULTANA

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