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21D2263026 CLIA NUMBER - EXCELSIOR HEALTHCARE ENTERSPRISES

Laboratory Demographics

CLIA Number: 21D2263026

Facility Name: EXCELSIOR HEALTHCARE ENTERSPRISES

Facility Address:
12520 FAIRWOOD PARKWAY
BOWIE, MD
ZIP 20720
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Facility Phone Number: 240 486-1100

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1225781305

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 21D2263026
LAB Type Physician Office
Facility Name EXCELSIOR HEALTHCARE ENTERSPRISES
Street 12520 FAIRWOOD PARKWAY
City BOWIE
State MD
ZIP 20720
Phone 240 486-1100
CertificateType 4
CertificateEffectiveDate 6/22/2022
CertificateExpirationDate 6/21/2024
FacilityType Waiver

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