21D2043394 CLIA NUMBER - FIRST CHOICE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 21D2043394
  • Facility Name: FIRST CHOICE PEDIATRICS
  • Facility Address: 1409 PENNSYLVANIA AVE, FIRST FLOOR
    HAGERSTOWN, MD
    ZIP 21742
  • Facility Phone: 301 797-4060
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MAHMOUD A. MUSTAFA
  • NPI Number: 1033498589
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D2043394
LAB Type Physician Office
Facility Name FIRST CHOICE PEDIATRICS
Street 1409 PENNSYLVANIA AVE, FIRST FLOOR
City HAGERSTOWN
State MD
ZIP 21742
Phone 301 797-4060
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2024
Certificate Expiration Date 7/1/2026
Facility Type Physician Office
Lab Director DR. MAHMOUD A. MUSTAFA

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