21D2212382 CLIA NUMBER - SURGERY CENTER AT PARK POTOMAC

Laboratory Demographics

CLIA Number: 21D2212382

Facility Name: SURGERY CENTER AT PARK POTOMAC

Facility Address:
7811 MONTROSE ROAD #330
POTOMAC, MD
ZIP 20854
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Facility Phone Number: 301 335-4149

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1972109940

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D2212382
LAB Type	Ambulatory Surgery Center
Facility Name	SURGERY CENTER AT PARK POTOMAC
Street	7811 MONTROSE ROAD #330
City	POTOMAC
State	MD
ZIP	20854
Phone	301 335-4149
CertificateType	4
CertificateEffectiveDate	2/4/2023
CertificateExpirationDate	2/3/2025
FacilityType	Waiver

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