21D1072465 CLIA NUMBER - FAMILY MEDICAL CENTER LLC

Laboratory Demographics

  • CLIA Code: 21D1072465
  • Facility Name: FAMILY MEDICAL CENTER LLC
  • Facility Address: 1502 SOUTH MAIN STREET SUITE 206
    MOUNT AIRY, MD
    ZIP 21771
  • Facility Phone: 301 829-1887
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ROCHELLE DYER CRNP
  • NPI Number: 1750824082
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D1072465
LAB Type Practitioner Other
Facility Name FAMILY MEDICAL CENTER LLC
Street 1502 SOUTH MAIN STREET SUITE 206
City MOUNT AIRY
State MD
ZIP 21771
Phone 301 829-1887
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2025
Certificate Expiration Date 8/16/2027
Facility Type Practitioner Other
Lab Director ROCHELLE DYER CRNP

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