21D2165318 CLIA NUMBER - TRUE PHOENIX COMMUNITY CARE LLC

Laboratory Demographics

  • CLIA Code: 21D2165318
  • Facility Name: TRUE PHOENIX COMMUNITY CARE LLC
  • Facility Address: 2316 E JOPPA RD STE 1
    PARKVILLE, MD
    ZIP 21234
  • Facility Phone: (443) 793-7220
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JINAYA S. BEATTY
  • NPI Number: 1790249084
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2165318
LAB Type Practitioner Other
Facility Name TRUE PHOENIX COMMUNITY CARE LLC
Street 2316 E JOPPA RD STE 1
City PARKVILLE
State MD
ZIP 21234
Phone 4437937220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2025
Certificate Expiration Date 4/24/2027
Facility Type Practitioner Other
Lab Director JINAYA S. BEATTY

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This page was last updated on: 5/18/2026