21D2079281 CLIA NUMBER - MEDSTAR URGENT CARE LLC

Laboratory Demographics

  • CLIA Code: 21D2079281
  • Facility Name: MEDSTAR URGENT CARE LLC
  • Facility Address: 1420 KEY HIGHWAY STE 200
    BALTIMORE, MD
    ZIP 21230
  • Facility Phone: 410 230-7820
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: BRONSON E. DELASOBERA
  • NPI Number: 1447662663
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2079281
LAB Type Other - URGENT CARE
Facility Name MEDSTAR URGENT CARE LLC
Street 1420 KEY HIGHWAY STE 200
City BALTIMORE
State MD
ZIP 21230
Phone 410 230-7820
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2024
Certificate Expiration Date 6/12/2026
Facility Type Other - URGENT CARE
Lab Director BRONSON E. DELASOBERA

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