21D2259700 CLIA NUMBER - ADVANCED DERMATOLOGY OF MARYLAND

Laboratory Demographics

CLIA Number: 21D2259700

Facility Name: ADVANCED DERMATOLOGY OF MARYLAND

Facility Address:
18109 PRINCE PHILIP DRIVE #370
OLNEY, MD
ZIP 20832
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Facility Phone Number: 407 284-3407

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1356931539

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	21D2259700
LAB Type	Physician Office
Facility Name	ADVANCED DERMATOLOGY OF MARYLAND
Street	18109 PRINCE PHILIP DRIVE #370
City	OLNEY
State	MD
ZIP	20832
Phone	407 284-3407
CertificateType	4
CertificateEffectiveDate	5/10/2024
CertificateExpirationDate	5/9/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024