21D2216980 CLIA NUMBER - ELLICOTT CITY PRIMARY CARE, LLC

Laboratory Demographics

  • CLIA Code: 21D2216980
  • Facility Name: ELLICOTT CITY PRIMARY CARE, LLC
  • Facility Address: 9055 CHEVROLET DR SUITE 100
    ELLICOTT CITY, MD
    ZIP 21042
  • Facility Phone: 410 862-8860
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DEBORAH CURTIS
  • NPI Number: 1720661812
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2216980
LAB Type Physician Office
Facility Name ELLICOTT CITY PRIMARY CARE, LLC
Street 9055 CHEVROLET DR SUITE 100
City ELLICOTT CITY
State MD
ZIP 21042
Phone 410 862-8860
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type Physician Office
Lab Director DEBORAH CURTIS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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