21D2269720 CLIA NUMBER - PLEASANT VALLEY PRIMARY CARE, LLC

Laboratory Demographics

  • CLIA Code: 21D2269720
  • Facility Name: PLEASANT VALLEY PRIMARY CARE, LLC
  • Facility Address: 20311 LAPPANS RD #100
    BOONSBORO, MD
    ZIP 21713
  • Facility Phone: 301 573-9453
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DAVID H. ROELKEY
  • NPI Number: 1346962149
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2269720
LAB Type Physician Office
Facility Name PLEASANT VALLEY PRIMARY CARE, LLC
Street 20311 LAPPANS RD #100
City BOONSBORO
State MD
ZIP 21713
Phone 301 573-9453
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Physician Office
Lab Director DR. DAVID H. ROELKEY

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