21D1007209 CLIA NUMBER - JOHN WHITTAKER MD LLC

Laboratory Demographics

  • CLIA Code: 21D1007209
  • Facility Name: JOHN WHITTAKER MD LLC
  • Facility Address: 1035 OCEAN HIGHWAY
    POCOMOKE CITY, MD
    ZIP 21851
  • Facility Phone: 410 957-7071
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN D. WHITTAKER
  • NPI Number: 1548220692
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D1007209
LAB Type Physician Office
Facility Name JOHN WHITTAKER MD LLC
Street 1035 OCEAN HIGHWAY
City POCOMOKE CITY
State MD
ZIP 21851
Phone 410 957-7071
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Physician Office
Lab Director JOHN D. WHITTAKER

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