21D2097919 CLIA NUMBER - EXPRESSCARE OF LARGO

Laboratory Demographics

  • CLIA Code: 21D2097919
  • Facility Name: EXPRESSCARE OF LARGO
  • Facility Address: 10416 CAMPUS WAY SOUTH
    UPPER MARLBORO, MD
    ZIP 20774
  • Facility Phone: 302 233-6237
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: SITTA GOMBEH-ALIE
  • NPI Number: 1194195008
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2097919
LAB Type Community Clinic
Facility Name EXPRESSCARE OF LARGO
Street 10416 CAMPUS WAY SOUTH
City UPPER MARLBORO
State MD
ZIP 20774
Phone 302 233-6237
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2025
Certificate Expiration Date 6/25/2027
Facility Type Community Clinic
Lab Director SITTA GOMBEH-ALIE

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