21D2027986 CLIA NUMBER - MINUTE CLINIC LLC #4017

Laboratory Demographics

  • CLIA Code: 21D2027986
  • Facility Name: MINUTE CLINIC LLC #4017
  • Facility Address: 28 MAGOTHY BEACH ROAD
    PASADENA, MD
    ZIP 21122
  • Facility Phone: 401 770-6453
  • Facility Type: Other - HEALTH CARE CLINIC
  • Facility Type: Waiver
  • Lab Director: MINOKA MCPHERSON
  • NPI Number: 1821809187
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2027986
LAB Type Other - HEALTH CARE CLINIC
Facility Name MINUTE CLINIC LLC #4017
Street 28 MAGOTHY BEACH ROAD
City PASADENA
State MD
ZIP 21122
Phone 401 770-6453
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/5/2025
Certificate Expiration Date 8/4/2027
Facility Type Other - HEALTH CARE CLINIC
Lab Director MINOKA MCPHERSON

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