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21D1010496 CLIA NUMBER - GEORGE H WATHEN MD FACP

Laboratory Demographics

CLIA Number: 21D1010496

Facility Name: GEORGE H WATHEN MD FACP

Facility Address:
11345 PEMBROOKE SQUARE STE 103
WALDORF, MD
ZIP 20603
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Facility Phone Number: 301 645-8144

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1861453284

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 21D1010496
LAB Type Physician Office
Facility Name GEORGE H WATHEN MD FACP
Street 11345 PEMBROOKE SQUARE STE 103
City WALDORF
State MD
ZIP 20603
Phone 301 645-8144
CertificateType 3
CertificateEffectiveDate 6/29/2022
CertificateExpirationDate 6/28/2024
FacilityType PPMP

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This page was last updated on: 4/23/2024