21D2059496 CLIA NUMBER - CENTER FOR CLINICAL RESOURCE MANAGEMENT

Laboratory Demographics

  • CLIA Code: 21D2059496
  • Facility Name: CENTER FOR CLINICAL RESOURCE MANAGEMENT
  • Facility Address: 12502 WILLOWBROOK ROAD SUITE 300
    CUMBERLAND, MD
    ZIP 21502
  • Facility Phone: 240 964-4812
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: EMILY GAMMOH
  • NPI Number: 1619444213
  • Taxonomy: 332900000X - Non-Pharmacy Dispensing Site

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CLIA Record

Field Name Field Value
CLIA Number 21D2059496
LAB Type Practitioner Other
Facility Name CENTER FOR CLINICAL RESOURCE MANAGEMENT
Street 12502 WILLOWBROOK ROAD SUITE 300
City CUMBERLAND
State MD
ZIP 21502
Phone 240 964-4812
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2025
Certificate Expiration Date 5/22/2027
Facility Type Practitioner Other
Lab Director EMILY GAMMOH

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