21D2241426 CLIA NUMBER - SPENCER FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 21D2241426
  • Facility Name: SPENCER FAMILY PRACTICE
  • Facility Address: 8061 SPRINGFIELD ROAD
    GLENN DALE, MD
    ZIP 20769
  • Facility Phone: 434 390-6641
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARY L. SPENCER
  • NPI Number: 1568032464
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2241426
LAB Type Physician Office
Facility Name SPENCER FAMILY PRACTICE
Street 8061 SPRINGFIELD ROAD
City GLENN DALE
State MD
ZIP 20769
Phone 434 390-6641
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Physician Office
Lab Director MARY L. SPENCER

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