21D1021165 CLIA NUMBER - CYNTHIA J MOORMAN MD PA

Laboratory Demographics

  • CLIA Code: 21D1021165
  • Facility Name: CYNTHIA J MOORMAN MD PA
  • Facility Address: 77 THOMAS JOHNSON DRIVE STE K
    FREDERICK, MD
    ZIP 21702
  • Facility Phone: 301 662-4868
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CYNTHIA J. MOORMAN MD
  • NPI Number: 1700866191
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 21D1021165
LAB Type Physician Office
Facility Name CYNTHIA J MOORMAN MD PA
Street 77 THOMAS JOHNSON DRIVE STE K
City FREDERICK
State MD
ZIP 21702
Phone 301 662-4868
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/14/2024
Certificate Expiration Date 1/13/2026
Facility Type Physician Office
Lab Director CYNTHIA J. MOORMAN MD

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