21D2109575 CLIA NUMBER - KATZEN MEDICAL ASSOCIATES PC

Laboratory Demographics

  • CLIA Code: 21D2109575
  • Facility Name: KATZEN MEDICAL ASSOCIATES PC
  • Facility Address: 111 MT CARMEL RD SUITE 600
    PARKTON, MD
    ZIP 21120
  • Facility Phone: 410 329-6700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. LORI A. SPORTELLI
  • NPI Number: 1093221392
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 21D2109575
LAB Type Physician Office
Facility Name KATZEN MEDICAL ASSOCIATES PC
Street 111 MT CARMEL RD SUITE 600
City PARKTON
State MD
ZIP 21120
Phone 410 329-6700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/29/2024
Certificate Expiration Date 2/27/2026
Facility Type Physician Office
Lab Director DR. LORI A. SPORTELLI

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