21D1065542 CLIA NUMBER - KAREN JILL CICCARELLI MD PC

Laboratory Demographics

  • CLIA Code: 21D1065542
  • Facility Name: KAREN JILL CICCARELLI MD PC
  • Facility Address: 16605 KENDLE ROAD
    WILLIAMSPORT, MD
    ZIP 21795
  • Facility Phone: 301 223-1241
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KAREN J. CICCARELLI
  • NPI Number: 1619010170
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D1065542
LAB Type Physician Office
Facility Name KAREN JILL CICCARELLI MD PC
Street 16605 KENDLE ROAD
City WILLIAMSPORT
State MD
ZIP 21795
Phone 301 223-1241
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Physician Office
Lab Director KAREN J. CICCARELLI

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