21D2263486 CLIA NUMBER - IMPACT DIAGNOSTIC LAB & HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 21D2263486
  • Facility Name: IMPACT DIAGNOSTIC LAB & HEALTH SERVICES
  • Facility Address: 1300 MERCANTILE LANE SUITE 136-A
    LARGO, MD
    ZIP 20774
  • Facility Phone: 301 883-1047
  • Facility Type: Other - DIAGNOSTIC TESTING LAB
  • Facility Type: Waiver
  • Lab Director: ELIZABETH AKINFIRESOYE
  • NPI Number: 1821728031
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2263486
LAB Type Other - DIAGNOSTIC TESTING LAB
Facility Name IMPACT DIAGNOSTIC LAB & HEALTH SERVICES
Street 1300 MERCANTILE LANE SUITE 136-A
City LARGO
State MD
ZIP 20774
Phone 301 883-1047
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2024
Certificate Expiration Date 6/28/2026
Facility Type Other - DIAGNOSTIC TESTING LAB
Lab Director ELIZABETH AKINFIRESOYE

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