21D2142065 CLIA NUMBER - EXPRESSCARE OF SEVERNA PARK

Laboratory Demographics

  • CLIA Code: 21D2142065
  • Facility Name: EXPRESSCARE OF SEVERNA PARK
  • Facility Address: 153 RITCHIE HIGHWAY
    SEVERNA PARK, MD
    ZIP 21146
  • Facility Phone: 302 233-6237
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: SITTA GOMBEH-ALIE
  • NPI Number: 1164925202
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2142065
LAB Type Community Clinic
Facility Name EXPRESSCARE OF SEVERNA PARK
Street 153 RITCHIE HIGHWAY
City SEVERNA PARK
State MD
ZIP 21146
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 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Community Clinic
Lab Director SITTA GOMBEH-ALIE

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