21D2255317 CLIA NUMBER - CENTENNIAL MEDICAL GROUP - RESEARCH

Laboratory Demographics

  • CLIA Code: 21D2255317
  • Facility Name: CENTENNIAL MEDICAL GROUP - RESEARCH
  • Facility Address: 6250 OLD DOBBIN LN SUITE B
    COLUMBIA, MD
    ZIP 21045
  • Facility Phone: 410 730-3399
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RAJIV DUA
  • NPI Number: 1922650498
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2255317
LAB Type Physician Office
Facility Name CENTENNIAL MEDICAL GROUP - RESEARCH
Street 6250 OLD DOBBIN LN SUITE B
City COLUMBIA
State MD
ZIP 21045
Phone 410 730-3399
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/14/2024
Certificate Expiration Date 3/13/2026
Facility Type Physician Office
Lab Director DR. RAJIV DUA

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