21D2242103 CLIA NUMBER - ANNAPOLIS INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 21D2242103
  • Facility Name: ANNAPOLIS INTERNAL MEDICINE
  • Facility Address: 116 DEFENSE HIGHWAY SUITE 104
    ANNAPOLIS, MD
    ZIP 21401
  • Facility Phone: 410 897-9841
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RITA J. SHKULLAKU
  • NPI Number: 1477629681
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2242103
LAB Type Physician Office
Facility Name ANNAPOLIS INTERNAL MEDICINE
Street 116 DEFENSE HIGHWAY SUITE 104
City ANNAPOLIS
State MD
ZIP 21401
Phone 410 897-9841
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2023
Certificate Expiration Date 11/3/2025
Facility Type Physician Office
Lab Director RITA J. SHKULLAKU

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