21D2139930 CLIA NUMBER - EXPRESSCARE OF MIDDLE RIVER

Laboratory Demographics

  • CLIA Code: 21D2139930
  • Facility Name: EXPRESSCARE OF MIDDLE RIVER
  • Facility Address: 1470 MARTINS BOULEVARD
    MIDDLE RIVER, MD
    ZIP 21220
  • Facility Phone: 302 233-6237
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: SITTA GOMBEH-ALIE
  • NPI Number: 1871031872
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2139930
LAB Type Community Clinic
Facility Name EXPRESSCARE OF MIDDLE RIVER
Street 1470 MARTINS BOULEVARD
City MIDDLE RIVER
State MD
ZIP 21220
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 11/13/2023
Certificate Expiration Date 11/12/2025
Facility Type Community Clinic
Lab Director SITTA GOMBEH-ALIE

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