21D1013981 CLIA NUMBER - PREVENTIVE CARE NETWORK SERVICES PC

Laboratory Demographics

  • CLIA Code: 21D1013981
  • Facility Name: PREVENTIVE CARE NETWORK SERVICES PC
  • Facility Address: 9001 WOODYARD ROAD, SUITE C
    CLINTON, MD
    ZIP 20735
  • Facility Phone: 301 868-7333
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VICTOR E. HERRY MD
  • NPI Number: 1548822232
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D1013981
LAB Type Physician Office
Facility Name PREVENTIVE CARE NETWORK SERVICES PC
Street 9001 WOODYARD ROAD, SUITE C
City CLINTON
State MD
ZIP 20735
Phone 301 868-7333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Physician Office
Lab Director VICTOR E. HERRY MD

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