21D2223265 CLIA NUMBER - ELITE PRIMARY CARE GROUP LLC

Laboratory Demographics

  • CLIA Code: 21D2223265
  • Facility Name: ELITE PRIMARY CARE GROUP LLC
  • Facility Address: 801 TOLL HOUSE AVENUE SUITE D-3
    FREDERICK, MD
    ZIP 21701
  • Facility Phone: 301 732-7875
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FAHIMA AZIZI
  • NPI Number: 1174112734
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2223265
LAB Type Physician Office
Facility Name ELITE PRIMARY CARE GROUP LLC
Street 801 TOLL HOUSE AVENUE SUITE D-3
City FREDERICK
State MD
ZIP 21701
Phone 301 732-7875
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2025
Certificate Expiration Date 5/4/2027
Facility Type Physician Office
Lab Director FAHIMA AZIZI

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