21D1068193 CLIA NUMBER - GENESIS FAMILY MEDICAL

Laboratory Demographics

  • CLIA Code: 21D1068193
  • Facility Name: GENESIS FAMILY MEDICAL
  • Facility Address: 6161 EXECUTIVE BLVD
    ROCKVILLE, MD
    ZIP 20852
  • Facility Phone: 301 871-3400
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: YOON J. CHO
  • NPI Number: 1275630824
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D1068193
LAB Type Physician Office
Facility Name GENESIS FAMILY MEDICAL
Street 6161 EXECUTIVE BLVD
City ROCKVILLE
State MD
ZIP 20852
Phone 301 871-3400
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 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Physician Office
Lab Director YOON J. CHO

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