21D1100586 CLIA NUMBER - CRESCENT URGENT HEALTH CARE SVCS DBA FAST TRACK URGENT CARE

Laboratory Demographics

CLIA Number: 21D1100586

Facility Name: CRESCENT URGENT HEALTH CARE SVCS DBA FAST TRACK URGENT CARE

Facility Address:
10540 CONNECTICUT AVE
KENSINGTON, MD
ZIP 20895
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Facility Phone Number: 301 949-0030

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1184059891

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D1100586
LAB Type	Physician Office
Facility Name	CRESCENT URGENT HEALTH CARE SVCS DBA FAST TRACK URGENT CARE
Street	10540 CONNECTICUT AVE
City	KENSINGTON
State	MD
ZIP	20895
Phone	301 949-0030
CertificateType	4
CertificateEffectiveDate	6/9/2023
CertificateExpirationDate	6/8/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024