21D2268045 CLIA NUMBER - PINNACLE FAMILY CARE PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 21D2268045
  • Facility Name: PINNACLE FAMILY CARE PRACTICE LLC
  • Facility Address: 10220 S DOLFIELD RD SUITE 105
    OWINGS MILLS, MD
    ZIP 21117
  • Facility Phone: 443 912-5077
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ADENIKE POPOOLA
  • NPI Number: 1053066936
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2268045
LAB Type Practitioner Other
Facility Name PINNACLE FAMILY CARE PRACTICE LLC
Street 10220 S DOLFIELD RD SUITE 105
City OWINGS MILLS
State MD
ZIP 21117
Phone 443 912-5077
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2024
Certificate Expiration Date 9/5/2026
Facility Type Practitioner Other
Lab Director ADENIKE POPOOLA

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