21D2089777 CLIA NUMBER - ANTHONY O ROBERTS, MD PC DBA SHADY GROVE OP

Home > CLIA Lookup > 21D2089777

Laboratory Demographics

CLIA Number: 21D2089777

Facility Name: ANTHONY O ROBERTS, MD PC DBA SHADY GROVE OP

Facility Address:
9715 MEDICAL CENTER DRIVE SUITE 502
ROCKVILLE, MD
ZIP 20850
Get Directions

Facility Phone Number: 301 279-2770

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1609933472

Taxonomy: 207RC0200X - Internal Medicine
An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

CLIA Record

Field Name	Field Value
CLIA Number	21D2089777
LAB Type	Physician Office
Facility Name	ANTHONY O ROBERTS, MD PC DBA SHADY GROVE OP
Street	9715 MEDICAL CENTER DRIVE SUITE 502
City	ROCKVILLE
State	MD
ZIP	20850
Phone	301 279-2770
CertificateType	4
CertificateEffectiveDate	1/8/2023
CertificateExpirationDate	1/7/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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