21D2079273 CLIA NUMBER - SUMMIT AMBULATORY SURGICAL CENTER, LLC

Laboratory Demographics

  • CLIA Code: 21D2079273
  • Facility Name: SUMMIT AMBULATORY SURGICAL CENTER, LLC
  • Facility Address: 7704 MATAPEAKE BUSSINESS DR
    BRANDYWINE, MD
    ZIP 20613
  • Facility Phone: 301 645-8838
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Microscopy
  • Lab Director: BRAD D. LERNER
  • NPI Number: 1659793040
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2079273
LAB Type Ambulatory Surgery Center
Facility Name SUMMIT AMBULATORY SURGICAL CENTER, LLC
Street 7704 MATAPEAKE BUSSINESS DR
City BRANDYWINE
State MD
ZIP 20613
Phone 301 645-8838
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/13/2024
Certificate Expiration Date 6/12/2026
Facility Type Ambulatory Surgery Center
Lab Director BRAD D. LERNER

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