21D2046823 CLIA NUMBER - DAWN BRODERICK, MD

Laboratory Demographics

  • CLIA Code: 21D2046823
  • Facility Name: DAWN BRODERICK, MD
  • Facility Address: 18111 PRINCE PHILIP DRIVE #201
    OLNEY, MD
    ZIP 20832
  • Facility Phone: 301 774-7714
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DAWN A. BRODERICK
  • NPI Number: 1801899489
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2046823
LAB Type Physician Office
Facility Name DAWN BRODERICK, MD
Street 18111 PRINCE PHILIP DRIVE #201
City OLNEY
State MD
ZIP 20832
Phone 301 774-7714
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2024
Certificate Expiration Date 9/11/2026
Facility Type Physician Office
Lab Director DR. DAWN A. BRODERICK

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