21D2033466 CLIA NUMBER - MIDDLEBROOK PEDIATRICS LLC

Laboratory Demographics

  • CLIA Code: 21D2033466
  • Facility Name: MIDDLEBROOK PEDIATRICS LLC
  • Facility Address: 18528 OFFICE PARK DRIVE
    MONTGOMERY VILLAGE, MD
    ZIP 20886
  • Facility Phone: 301 330-4130
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VERONICA OMENKA
  • NPI Number: 1285098137
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2033466
LAB Type Physician Office
Facility Name MIDDLEBROOK PEDIATRICS LLC
Street 18528 OFFICE PARK DRIVE
City MONTGOMERY VILLAGE
State MD
ZIP 20886
Phone 301 330-4130
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Physician Office
Lab Director VERONICA OMENKA

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