21D2059933 CLIA NUMBER - MINUTECLINIC, LLC #1796

Laboratory Demographics

  • CLIA Code: 21D2059933
  • Facility Name: MINUTECLINIC, LLC #1796
  • Facility Address: 4200 ALTAMONT PLACE
    WHITE PLAINS, MD
    ZIP 20695
  • Facility Phone: 401 770-6453
  • Facility Type: Other - LIMITED SERV HLTH CARE CL
  • Facility Type: Waiver
  • Lab Director: MINOKA MCPHERSON
  • NPI Number: 1992516181
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2059933
LAB Type Other - LIMITED SERV HLTH CARE CL
Facility Name MINUTECLINIC, LLC #1796
Street 4200 ALTAMONT PLACE
City WHITE PLAINS
State MD
ZIP 20695
Phone 401 770-6453
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/4/2025
Certificate Expiration Date 6/3/2027
Facility Type Other - LIMITED SERV HLTH CARE CL
Lab Director MINOKA MCPHERSON

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