21D2105584 CLIA NUMBER - CLARKSBURG PEDIATRICS LLC

Laboratory Demographics

  • CLIA Code: 21D2105584
  • Facility Name: CLARKSBURG PEDIATRICS LLC
  • Facility Address: 18506 OFFICE PARK DR
    MONTGOMERY VILLAGE, MD
    ZIP 20886
  • Facility Phone: 301 869-3530
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ARMINA M. RAHMAN
  • NPI Number: 1255157434
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D2105584
LAB Type Physician Office
Facility Name CLARKSBURG PEDIATRICS LLC
Street 18506 OFFICE PARK DR
City MONTGOMERY VILLAGE
State MD
ZIP 20886
Phone 301 869-3530
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/1/2023
Certificate Expiration Date 11/30/2025
Facility Type Physician Office
Lab Director ARMINA M. RAHMAN

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