21D2165805 CLIA NUMBER - MOUNTAIN LAUREL MEDICAL CENTER- WESTERNPORT

Laboratory Demographics

CLIA Number: 21D2165805

Facility Name: MOUNTAIN LAUREL MEDICAL CENTER- WESTERNPORT

Facility Address:
22221 WESTERNPORT RD SW
WESTERNPORT, MD
ZIP 21562
Get Directions

Facility Phone Number: 301 533-3300

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1053727065

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D2165805
LAB Type	Federally Qualified Health Center
Facility Name	MOUNTAIN LAUREL MEDICAL CENTER- WESTERNPORT
Street	22221 WESTERNPORT RD SW
City	WESTERNPORT
State	MD
ZIP	21562
Phone	301 533-3300
CertificateType	3
CertificateEffectiveDate	5/7/2023
CertificateExpirationDate	5/6/2025
FacilityType	PPMP

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024