21D2041795 CLIA NUMBER - ARS AN AFFILIATE OF MARYLAND IMAGING NETWORK

Laboratory Demographics

  • CLIA Code: 21D2041795
  • Facility Name: ARS AN AFFILIATE OF MARYLAND IMAGING NETWORK
  • Facility Address: 10400 ODONNELL PL SUITE 100
    WALDORF, MD
    ZIP 20603
  • Facility Phone: 301 870-8434
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARK WHITAKER
  • NPI Number: 1508405317
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2041795
LAB Type Physician Office
Facility Name ARS AN AFFILIATE OF MARYLAND IMAGING NETWORK
Street 10400 ODONNELL PL SUITE 100
City WALDORF
State MD
ZIP 20603
Phone 301 870-8434
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/30/2024
Certificate Expiration Date 5/29/2026
Facility Type Physician Office
Lab Director DR. MARK WHITAKER

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