21D2067878 CLIA NUMBER - WHITE PLAINS PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 21D2067878
  • Facility Name: WHITE PLAINS PRIMARY CARE
  • Facility Address: 50 POST OFFICE ROAD STE 304
    WALDORF, MD
    ZIP 20602
  • Facility Phone: 240 349-2448
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JENNIFER MCMANUS CRNP
  • NPI Number: 1720424450
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2067878
LAB Type Practitioner Other
Facility Name WHITE PLAINS PRIMARY CARE
Street 50 POST OFFICE ROAD STE 304
City WALDORF
State MD
ZIP 20602
Phone 240 349-2448
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2023
Certificate Expiration Date 10/23/2025
Facility Type Practitioner Other
Lab Director JENNIFER MCMANUS CRNP

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