21D1010853 CLIA NUMBER - PARK PEDIATRICS TAKOMA PARK

Laboratory Demographics

  • CLIA Code: 21D1010853
  • Facility Name: PARK PEDIATRICS TAKOMA PARK
  • Facility Address: 7610 CARROLL AVENUE STE 400
    TAKOMA PARK, MD
    ZIP 20912
  • Facility Phone: 301 891-6141
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAVANYA SITHANANDAM
  • NPI Number: 1144695529
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D1010853
LAB Type Physician Office
Facility Name PARK PEDIATRICS TAKOMA PARK
Street 7610 CARROLL AVENUE STE 400
City TAKOMA PARK
State MD
ZIP 20912
Phone 301 891-6141
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Physician Office
Lab Director LAVANYA SITHANANDAM

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