21D2072054 CLIA NUMBER - MEDSTAR URGENT CARE LLC

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Laboratory Demographics

CLIA Number: 21D2072054

Facility Name: MEDSTAR URGENT CARE LLC

Facility Address:
19777 N FREDERICK ROAD
GERMANTOWN, MD
ZIP 20876
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Facility Phone Number: 410 772-6909

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1538923958

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	21D2072054
LAB Type	Other - URGENT CARE
Facility Name	MEDSTAR URGENT CARE LLC
Street	19777 N FREDERICK ROAD
City	GERMANTOWN
State	MD
ZIP	20876
Phone	410 772-6909
CertificateType	4
CertificateEffectiveDate	4/1/2023
CertificateExpirationDate	3/31/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024