21D2162856 CLIA NUMBER - PRINCIPLE DIAGNOSTIC LABORATORY

Laboratory Demographics

  • CLIA Code: 21D2162856
  • Facility Name: PRINCIPLE DIAGNOSTIC LABORATORY
  • Facility Address: 253 LEWIS LANE SUITE 302
    HAVRE DE GRACE, MD
    ZIP 21078
  • Facility Phone: 484 353-6661
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: YAROSLAV KRYMSKIY
  • NPI Number: 1346648870
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 21D2162856
LAB Type Physician Office
Facility Name PRINCIPLE DIAGNOSTIC LABORATORY
Street 253 LEWIS LANE SUITE 302
City HAVRE DE GRACE
State MD
ZIP 21078
Phone 484 353-6661
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2025
Certificate Expiration Date 3/3/2027
Facility Type Physician Office
Lab Director YAROSLAV KRYMSKIY

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