21D2254750 CLIA NUMBER - MARYLAND JOCKEY CLUB INC, THE

Laboratory Demographics

  • CLIA Code: 21D2254750
  • Facility Name: MARYLAND JOCKEY CLUB INC, THE
  • Facility Address: 3600 FORT MEADE RD
    LAUREL, MD
    ZIP 20724
  • Facility Phone: 301 470-5435
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: MEAGAN LEWIS
  • NPI Number: 1821010570
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D2254750
LAB Type Ambulance
Facility Name MARYLAND JOCKEY CLUB INC, THE
Street 3600 FORT MEADE RD
City LAUREL
State MD
ZIP 20724
Phone 301 470-5435
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/7/2024
Certificate Expiration Date 3/6/2026
Facility Type Ambulance
Lab Director MEAGAN LEWIS

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