21D2136938 CLIA NUMBER - COLLEGE PARK MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 21D2136938
  • Facility Name: COLLEGE PARK MEDICAL CENTER
  • Facility Address: 4701 MELBOURNE PLACE
    COLLEGE PARK, MD
    ZIP 20740
  • Facility Phone: 301 345-4400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. OUSSAMA MHAMDI
  • NPI Number: 1962711614
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2136938
LAB Type Physician Office
Facility Name COLLEGE PARK MEDICAL CENTER
Street 4701 MELBOURNE PLACE
City COLLEGE PARK
State MD
ZIP 20740
Phone 301 345-4400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2025
Certificate Expiration Date 6/24/2027
Facility Type Physician Office
Lab Director DR. OUSSAMA MHAMDI

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