21D2157863 CLIA NUMBER - CITYWORLD FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 21D2157863
  • Facility Name: CITYWORLD FAMILY PRACTICE LLC
  • Facility Address: 6201 GREENBELT RD #M14
    COLLEGE PARK, MD
    ZIP 20740
  • Facility Phone: 301 289-7722
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MIRANDA B. MBUTAMBE
  • NPI Number: 1073089959
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2157863
LAB Type Practitioner Other
Facility Name CITYWORLD FAMILY PRACTICE LLC
Street 6201 GREENBELT RD #M14
City COLLEGE PARK
State MD
ZIP 20740
Phone 301 289-7722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type Practitioner Other
Lab Director MIRANDA B. MBUTAMBE

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