21D2075096 CLIA NUMBER - PARTNER MD MARYLAND PC

Laboratory Demographics

  • CLIA Code: 21D2075096
  • Facility Name: PARTNER MD MARYLAND PC
  • Facility Address: 9 PARK CENTER COURT STE 200
    OWINGS MILLS, MD
    ZIP 21117
  • Facility Phone: 804 282-2655
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELLIE P. GOLDBLOOM
  • NPI Number: 1255409371
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2075096
LAB Type Physician Office
Facility Name PARTNER MD MARYLAND PC
Street 9 PARK CENTER COURT STE 200
City OWINGS MILLS
State MD
ZIP 21117
Phone 804 282-2655
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2024
Certificate Expiration Date 3/23/2026
Facility Type Physician Office
Lab Director ELLIE P. GOLDBLOOM

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