21D2107274 CLIA NUMBER - PARK PEDIATRICS-GREENBELT

Laboratory Demographics

  • CLIA Code: 21D2107274
  • Facility Name: PARK PEDIATRICS-GREENBELT
  • Facility Address: 7500 HANOVER PARKWAY SUITE 204
    GREENBELT, MD
    ZIP 20770
  • Facility Phone: 301 232-3638
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAVANYA SITHANANDAM
  • NPI Number: 1710797303
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2107274
LAB Type Physician Office
Facility Name PARK PEDIATRICS-GREENBELT
Street 7500 HANOVER PARKWAY SUITE 204
City GREENBELT
State MD
ZIP 20770
Phone 301 232-3638
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Physician Office
Lab Director LAVANYA SITHANANDAM

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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