21D2239579 CLIA NUMBER - MYND PATH PSYCHIATRY AND MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 21D2239579
  • Facility Name: MYND PATH PSYCHIATRY AND MEDICAL ASSOCIATES
  • Facility Address: 188 THOMAS JOHNSON DR #202 UNIT 2B
    FREDERICK, MD
    ZIP 21702
  • Facility Phone: 443 820-5796
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: MANDI RHONE
  • NPI Number: 1538748470
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2239579
LAB Type Practitioner Other
Facility Name MYND PATH PSYCHIATRY AND MEDICAL ASSOCIATES
Street 188 THOMAS JOHNSON DR #202 UNIT 2B
City FREDERICK
State MD
ZIP 21702
Phone 443 820-5796
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2023
Certificate Expiration Date 10/12/2025
Facility Type Practitioner Other
Lab Director MANDI RHONE

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