21D2186621 CLIA NUMBER - GOLDEN PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 21D2186621
  • Facility Name: GOLDEN PRIMARY CARE
  • Facility Address: 915 SETON DRIVE
    CUMBERLAND, MD
    ZIP 21502
  • Facility Phone: 240 503-1500
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ASHLEY B. GOLDEN
  • NPI Number: 1669095071
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2186621
LAB Type Practitioner Other
Facility Name GOLDEN PRIMARY CARE
Street 915 SETON DRIVE
City CUMBERLAND
State MD
ZIP 21502
Phone 240 503-1500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/19/2024
Certificate Expiration Date 6/18/2026
Facility Type Practitioner Other
Lab Director ASHLEY B. GOLDEN

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