21D2212389 CLIA NUMBER - MEM SCEPTER HOME & BEHAVIORAL

Laboratory Demographics

  • CLIA Code: 21D2212389
  • Facility Name: MEM SCEPTER HOME & BEHAVIORAL
  • Facility Address: 25484 POINT LOOKOUT RD STE 301AQ
    LEONARDTOWN, MD
    ZIP 20650
  • Facility Phone: 240 309-4111
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MODUPE O. ADENEKAN
  • NPI Number: 1407462559
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2212389
LAB Type Practitioner Other
Facility Name MEM SCEPTER HOME & BEHAVIORAL
Street 25484 POINT LOOKOUT RD STE 301AQ
City LEONARDTOWN
State MD
ZIP 20650
Phone 240 309-4111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/4/2025
Certificate Expiration Date 2/3/2027
Facility Type Practitioner Other
Lab Director MODUPE O. ADENEKAN

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