21D1024819 CLIA NUMBER - COMPLETE CARE FOR KIDS

Laboratory Demographics

  • CLIA Code: 21D1024819
  • Facility Name: COMPLETE CARE FOR KIDS
  • Facility Address: 12850 MIDDLEBROOK RD STE 200
    GERMANTOWN, MD
    ZIP 20874
  • Facility Phone: 301 540-5900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MISHA P. MARTIN
  • NPI Number: 1285760199
  • Taxonomy: 305R00000X - Preferred Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 21D1024819
LAB Type Physician Office
Facility Name COMPLETE CARE FOR KIDS
Street 12850 MIDDLEBROOK RD STE 200
City GERMANTOWN
State MD
ZIP 20874
Phone 301 540-5900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Physician Office
Lab Director MISHA P. MARTIN

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