21D2135243 CLIA NUMBER - EMBRACE PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 21D2135243
  • Facility Name: EMBRACE PRIMARY CARE LLC
  • Facility Address: 2101 MEDICAL PARK DRIVE SUITE 300
    SILVER SPRING, MD
    ZIP 20902
  • Facility Phone: 301 802-6493
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: THIAGO L. GIBSON
  • NPI Number: 1700311602
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2135243
LAB Type Practitioner Other
Facility Name EMBRACE PRIMARY CARE LLC
Street 2101 MEDICAL PARK DRIVE SUITE 300
City SILVER SPRING
State MD
ZIP 20902
Phone 301 802-6493
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2025
Certificate Expiration Date 8/16/2027
Facility Type Practitioner Other
Lab Director THIAGO L. GIBSON

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