21D2092218 CLIA NUMBER - KENNETH M KLEBANOW & ASSOCIATES

Laboratory Demographics

  • CLIA Code: 21D2092218
  • Facility Name: KENNETH M KLEBANOW & ASSOCIATES
  • Facility Address: 8827 COLUMBIA 100 PARKWAY #1A
    COLUMBIA, MD
    ZIP 21045
  • Facility Phone: 410 997-0500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANA E. WOLLNEY
  • NPI Number: 1912110735
  • Taxonomy: 1041C0700X - Social Worker

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CLIA Record

Field Name Field Value
CLIA Number 21D2092218
LAB Type Physician Office
Facility Name KENNETH M KLEBANOW & ASSOCIATES
Street 8827 COLUMBIA 100 PARKWAY #1A
City COLUMBIA
State MD
ZIP 21045
Phone 410 997-0500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Physician Office
Lab Director DANA E. WOLLNEY

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