21D2095047 CLIA NUMBER - HERITAGE PEDIATRICS, INC

Laboratory Demographics

  • CLIA Code: 21D2095047
  • Facility Name: HERITAGE PEDIATRICS, INC
  • Facility Address: 1450 MERCANTILE LANE SUITE 217
    LARGO, MD
    ZIP 20774
  • Facility Phone: 301 341-5000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BABAJIDE E. FADITAN
  • NPI Number: 1972903201
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D2095047
LAB Type Physician Office
Facility Name HERITAGE PEDIATRICS, INC
Street 1450 MERCANTILE LANE SUITE 217
City LARGO
State MD
ZIP 20774
Phone 301 341-5000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2025
Certificate Expiration Date 7/21/2027
Facility Type Physician Office
Lab Director BABAJIDE E. FADITAN

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