21D2097919 CLIA NUMBER - EXPRESSCARE OF LARGO LLC

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Laboratory Demographics

CLIA Number: 21D2097919

Facility Name: EXPRESSCARE OF LARGO LLC

Facility Address:
10416 CAMPUS WAY SOUTH
UPPER MARLBORO, MD
ZIP 20774
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Facility Phone Number: 302 233-6237

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1194195008

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D2097919
LAB Type	Community Clinic
Facility Name	EXPRESSCARE OF LARGO LLC
Street	10416 CAMPUS WAY SOUTH
City	UPPER MARLBORO
State	MD
ZIP	20774
Phone	302 233-6237
CertificateType	4
CertificateEffectiveDate	6/26/2023
CertificateExpirationDate	6/25/2025
FacilityType	Waiver

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