21D1037256 CLIA NUMBER - UPPER CHESAPEAKE PRIMARY CARE FOREST HILL

Laboratory Demographics

  • CLIA Code: 21D1037256
  • Facility Name: UPPER CHESAPEAKE PRIMARY CARE FOREST HILL
  • Facility Address: 2 COLGATE DRIVE STE 103
    FOREST HILL, MD
    ZIP 21050
  • Facility Phone: 410 420-0161
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALY NAGUIB
  • NPI Number: 1386490613
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D1037256
LAB Type Physician Office
Facility Name UPPER CHESAPEAKE PRIMARY CARE FOREST HILL
Street 2 COLGATE DRIVE STE 103
City FOREST HILL
State MD
ZIP 21050
Phone 410 420-0161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2025
Certificate Expiration Date 2/17/2027
Facility Type Physician Office
Lab Director ALY NAGUIB

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