21D2238178 CLIA NUMBER - KAISER PERMANENTE BOWIE FAIRWOOD MEDICAL CENTER

Laboratory Demographics

CLIA Number: 21D2238178

Facility Name: KAISER PERMANENTE BOWIE FAIRWOOD MEDICAL CENTER

Facility Address:
5400 HILL MEADE ROAD
BOWIE, MD
ZIP 20720
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Facility Phone Number: 301 816-6328

Facility Type: Health Main. Organization

Certificate Type: Microscopy

NPI Number: 1205420247

Taxonomy: 3336M0003X - Pharmacy
A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO's covered members only.

CLIA Record

Field Name	Field Value
CLIA Number	21D2238178
LAB Type	Health Main. Organization
Facility Name	KAISER PERMANENTE BOWIE FAIRWOOD MEDICAL CENTER
Street	5400 HILL MEADE ROAD
City	BOWIE
State	MD
ZIP	20720
Phone	301 816-6328
CertificateType	3
CertificateEffectiveDate	10/1/2023
CertificateExpirationDate	9/30/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024