21D2255391 CLIA NUMBER - THRIVE PRIMARY CARE, LLC

Laboratory Demographics

  • CLIA Code: 21D2255391
  • Facility Name: THRIVE PRIMARY CARE, LLC
  • Facility Address: 15364 - B PRINCE FREDERICK RD
    HUGHESVILLE, MD
    ZIP 20637
  • Facility Phone: 240 230-7125
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNIFER MOHLER
  • NPI Number: 1780351809
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2255391
LAB Type Physician Office
Facility Name THRIVE PRIMARY CARE, LLC
Street 15364 - B PRINCE FREDERICK RD
City HUGHESVILLE
State MD
ZIP 20637
Phone 240 230-7125
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 JENNIFER MOHLER

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