21D1000784 CLIA NUMBER - MIDDLEBROOK DIALYSIS

Laboratory Demographics

  • CLIA Code: 21D1000784
  • Facility Name: MIDDLEBROOK DIALYSIS
  • Facility Address: 12401 MIDDLEBROOK RD SSTE 160
    GERMANTOWN, MD
    ZIP 20874
  • Facility Phone: 301 540-6020
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: FARZAD ASSAR
  • NPI Number: 1437437159
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D1000784
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name MIDDLEBROOK DIALYSIS
Street 12401 MIDDLEBROOK RD SSTE 160
City GERMANTOWN
State MD
ZIP 20874
Phone 301 540-6020
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 End Stage Renal Disease Dialysis Facility
Lab Director FARZAD ASSAR

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