21D2121757 CLIA NUMBER - JILL PORTER CRNP PA

Laboratory Demographics

  • CLIA Code: 21D2121757
  • Facility Name: JILL PORTER CRNP PA
  • Facility Address: 1310 BELMONT AVE SUITE 302
    SALISBURY, MD
    ZIP 21804
  • Facility Phone: 443 358-5388
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JILL R. PORTER
  • NPI Number: 1053441881
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2121757
LAB Type Physician Office
Facility Name JILL PORTER CRNP PA
Street 1310 BELMONT AVE SUITE 302
City SALISBURY
State MD
ZIP 21804
Phone 443 358-5388
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Physician Office
Lab Director JILL R. PORTER

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