21D2120582 CLIA NUMBER - EXPRESSCARE OF MOUNT AIRY

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Laboratory Demographics

CLIA Number: 21D2120582

Facility Name: EXPRESSCARE OF MOUNT AIRY

Facility Address:
504 EAST RIDGEVILLE BLVD
MOUNT AIRY, MD
ZIP 21771
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Facility Phone Number: 302 233-6237

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1073963146

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D2120582
LAB Type	Community Clinic
Facility Name	EXPRESSCARE OF MOUNT AIRY
Street	504 EAST RIDGEVILLE BLVD
City	MOUNT AIRY
State	MD
ZIP	21771
Phone	302 233-6237
CertificateType	4
CertificateEffectiveDate	10/19/2022
CertificateExpirationDate	10/18/2024
FacilityType	Waiver

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