21D2179921 CLIA NUMBER - FALLSGROVE ENDOSCOPY CENTER LLC

Laboratory Demographics

  • CLIA Code: 21D2179921
  • Facility Name: FALLSGROVE ENDOSCOPY CENTER LLC
  • Facility Address: 15001 SHADY GROVE #400
    ROCKVILLE, MD
    ZIP 20850
  • Facility Phone: 301 800-7001
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: OLANMA OKOJI
  • NPI Number: 1972141455
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2179921
LAB Type Ambulatory Surgery Center
Facility Name FALLSGROVE ENDOSCOPY CENTER LLC
Street 15001 SHADY GROVE #400
City ROCKVILLE
State MD
ZIP 20850
Phone 301 800-7001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2024
Certificate Expiration Date 3/3/2026
Facility Type Ambulatory Surgery Center
Lab Director OLANMA OKOJI

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