21D2107525 CLIA NUMBER - EXPRESSCARE OF NORTHWEST

Laboratory Demographics

  • CLIA Code: 21D2107525
  • Facility Name: EXPRESSCARE OF NORTHWEST
  • Facility Address: 8600 LIBERTY ROAD
    RANDALLSTOWN, MD
    ZIP 21133
  • Facility Phone: 302 233-6237
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. SITTA GOMBEH-ALIE
  • NPI Number: 1902262587
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2107525
LAB Type Community Clinic
Facility Name EXPRESSCARE OF NORTHWEST
Street 8600 LIBERTY ROAD
City RANDALLSTOWN
State MD
ZIP 21133
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 1/15/2024
Certificate Expiration Date 1/14/2026
Facility Type Community Clinic
Lab Director DR. SITTA GOMBEH-ALIE

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