21D1075988 CLIA NUMBER - PRIMECARE MED CENTER LLC

Laboratory Demographics

  • CLIA Code: 21D1075988
  • Facility Name: PRIMECARE MED CENTER LLC
  • Facility Address: 11161 NEW HAMPSHIRE AVENUE SUITE 305
    SILVER SPRING, MD
    ZIP 20904
  • Facility Phone: 301 592-0062
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NNENNA I. OKIGBO
  • NPI Number: 1932225661
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D1075988
LAB Type Physician Office
Facility Name PRIMECARE MED CENTER LLC
Street 11161 NEW HAMPSHIRE AVENUE SUITE 305
City SILVER SPRING
State MD
ZIP 20904
Phone 301 592-0062
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Physician Office
Lab Director NNENNA I. OKIGBO

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