21D2195211 CLIA NUMBER - KAISER PERMANENTE GAITHERSBURG MED CTR MOHS DEPT

Laboratory Demographics

  • CLIA Code: 21D2195211
  • Facility Name: KAISER PERMANENTE GAITHERSBURG MED CTR MOHS DEPT
  • Facility Address: 655 WATKINS MILL RD
    GAITHERSBURG, MD
    ZIP 20879
  • Facility Phone: 301 500-4578
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: AMARACHI ESEONU
  • NPI Number: 1508298837
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2195211
LAB Type Physician Office
Facility Name KAISER PERMANENTE GAITHERSBURG MED CTR MOHS DEPT
Street 655 WATKINS MILL RD
City GAITHERSBURG
State MD
ZIP 20879
Phone 301 500-4578
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 8/31/2024
Certificate Expiration Date 8/30/2026
Facility Type Physician Office
Lab Director AMARACHI ESEONU

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This page was last updated on: 3/20/2025