21D1038255 CLIA NUMBER - DAVID E JALLER MD

Laboratory Demographics

  • CLIA Code: 21D1038255
  • Facility Name: DAVID E JALLER MD
  • Facility Address: 184 THOMAS JOHNSON DRIVE SUITE 200
    FREDERICK, MD
    ZIP 21702
  • Facility Phone: 301 624-5544
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DAVID E. JALLER
  • NPI Number: 1447221460
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D1038255
LAB Type Physician Office
Facility Name DAVID E JALLER MD
Street 184 THOMAS JOHNSON DRIVE SUITE 200
City FREDERICK
State MD
ZIP 21702
Phone 301 624-5544
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 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Physician Office
Lab Director DAVID E. JALLER

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