21D2221431 CLIA NUMBER - MADELIENE ELAINE LLC

Laboratory Demographics

  • CLIA Code: 21D2221431
  • Facility Name: MADELIENE ELAINE LLC
  • Facility Address: 5530 WISCONSIN AVENUE #612
    CHEVY CHASE, MD
    ZIP 20815
  • Facility Phone: 412 638-8585
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MADELIENE GAINERS
  • NPI Number: 1255910063
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2221431
LAB Type Physician Office
Facility Name MADELIENE ELAINE LLC
Street 5530 WISCONSIN AVENUE #612
City CHEVY CHASE
State MD
ZIP 20815
Phone 412 638-8585
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 4/21/2025
Certificate Expiration Date 4/20/2027
Facility Type Physician Office
Lab Director MADELIENE GAINERS

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