21D2216958 CLIA NUMBER - MANA DERMATOLOGY LLC

Laboratory Demographics

  • CLIA Code: 21D2216958
  • Facility Name: MANA DERMATOLOGY LLC
  • Facility Address: 7500 GREENWAY DR SUITE #1220
    GREENBELT, MD
    ZIP 20770
  • Facility Phone: 301 615-1986
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MANA OGHOLIKHAN
  • NPI Number: 1336748508
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 21D2216958
LAB Type Physician Office
Facility Name MANA DERMATOLOGY LLC
Street 7500 GREENWAY DR SUITE #1220
City GREENBELT
State MD
ZIP 20770
Phone 301 615-1986
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type Physician Office
Lab Director MANA OGHOLIKHAN

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