21D2110971 CLIA NUMBER - ADVENTIST MEDICAL GROUP UROLOGY

Laboratory Demographics

CLIA Number: 21D2110971

Facility Name: ADVENTIST MEDICAL GROUP UROLOGY

Facility Address:
8807 COLESVILLE ROAD 4TH FLOOR
SILVER SPRING, MD
ZIP 20910
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Facility Phone Number: 240 641-8360

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1003271537

Taxonomy: 261QR0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D2110971
LAB Type	Physician Office
Facility Name	ADVENTIST MEDICAL GROUP UROLOGY
Street	8807 COLESVILLE ROAD 4TH FLOOR
City	SILVER SPRING
State	MD
ZIP	20910
Phone	240 641-8360
CertificateType	4
CertificateEffectiveDate	3/29/2024
CertificateExpirationDate	3/28/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024