21D1045748 CLIA NUMBER - BOWIE STATE UNIVERSITY WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 21D1045748
  • Facility Name: BOWIE STATE UNIVERSITY WELLNESS CENTER
  • Facility Address: 14000 JERICHO PARK ROAD CRMC LL
    BOWIE, MD
    ZIP 20715
  • Facility Phone: 301 860-4177
  • Facility Type: School/Student Health Service
  • Facility Type: Microscopy
  • Lab Director: LI LIN CHIU
  • NPI Number: 1154888048
  • Taxonomy: 363LA2200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D1045748
LAB Type School/Student Health Service
Facility Name BOWIE STATE UNIVERSITY WELLNESS CENTER
Street 14000 JERICHO PARK ROAD CRMC LL
City BOWIE
State MD
ZIP 20715
Phone 301 860-4177
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 12/5/2024
Certificate Expiration Date 12/4/2026
Facility Type School/Student Health Service
Lab Director LI LIN CHIU

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