21D2113395 CLIA NUMBER - EXPRESSCARE OF LOCH RAVEN

Laboratory Demographics

  • CLIA Code: 21D2113395
  • Facility Name: EXPRESSCARE OF LOCH RAVEN
  • Facility Address: 8000 LOCH RAVEN BLVD
    TOWSON, MD
    ZIP 21286
  • Facility Phone: 302 233-6237
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: DR. SITTA GOMBEH-ALIE
  • NPI Number: 1598118168
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2113395
LAB Type Community Clinic
Facility Name EXPRESSCARE OF LOCH RAVEN
Street 8000 LOCH RAVEN BLVD
City TOWSON
State MD
ZIP 21286
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 5/23/2024
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director DR. SITTA GOMBEH-ALIE

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