21D2156057 CLIA NUMBER - ST JUDE LABORATORY LLC

Laboratory Demographics

  • CLIA Code: 21D2156057
  • Facility Name: ST JUDE LABORATORY LLC
  • Facility Address: 8950 ROUTE 108 #121
    COLUMBIA, MD
    ZIP 21045
  • Facility Phone: 301 758-4390
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. BOSE KALAMPANAYIL
  • NPI Number: 1083172043
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 21D2156057
LAB Type Independent
Facility Name ST JUDE LABORATORY LLC
Street 8950 ROUTE 108 #121
City COLUMBIA
State MD
ZIP 21045
Phone 301 758-4390
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 9/1/2025
Certificate Expiration Date 8/31/2027
Facility Type Independent
Lab Director DR. BOSE KALAMPANAYIL

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