21D2144868 CLIA NUMBER - PSM ADULT MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 21D2144868
  • Facility Name: PSM ADULT MEDICAL CENTER
  • Facility Address: 13970 BALTIMORE AVENUE C-9
    LAUREL, MD
    ZIP 20707
  • Facility Phone: 240 720-6589
  • Facility Type: Other - ADULT MEDICAL DAYCARE
  • Facility Type: Waiver
  • Lab Director: PRAGNABEN J. PATEL RN
  • NPI Number: 1568965317
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2144868
LAB Type Other - ADULT MEDICAL DAYCARE
Facility Name PSM ADULT MEDICAL CENTER
Street 13970 BALTIMORE AVENUE C-9
City LAUREL
State MD
ZIP 20707
Phone 240 720-6589
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/26/2024
Certificate Expiration Date 2/25/2026
Facility Type Other - ADULT MEDICAL DAYCARE
Lab Director PRAGNABEN J. PATEL RN

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