21D1003412 CLIA NUMBER - MARLBORO LEASING CO LLC DBA FORESTVILLE HEALTHCARE

Laboratory Demographics

  • CLIA Code: 21D1003412
  • Facility Name: MARLBORO LEASING CO LLC DBA FORESTVILLE HEALTHCARE
  • Facility Address: 7240 MARLBORO PIKE
    FORESTVILLE, MD
    ZIP 20747
  • Facility Phone: 513 530-1808
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: DR. MITUL DAVE
  • NPI Number: 1679750897
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 21D1003412
LAB Type Home Health Agency
Facility Name MARLBORO LEASING CO LLC DBA FORESTVILLE HEALTHCARE
Street 7240 MARLBORO PIKE
City FORESTVILLE
State MD
ZIP 20747
Phone 513 530-1808
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2024
Certificate Expiration Date 8/28/2026
Facility Type Home Health Agency
Lab Director DR. MITUL DAVE

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