21D2272259 CLIA NUMBER - PG COUNTY ENDOSCOPY CENTER LLC

Laboratory Demographics

  • CLIA Code: 21D2272259
  • Facility Name: PG COUNTY ENDOSCOPY CENTER LLC
  • Facility Address: 6502 KENILWORTH AVENUE #200
    RIVERDALE, MD
    ZIP 20737
  • Facility Phone: 410 290-6677
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. FARZIN RASHTI
  • NPI Number: 1629713730
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2272259
LAB Type Ambulatory Surgery Center
Facility Name PG COUNTY ENDOSCOPY CENTER LLC
Street 6502 KENILWORTH AVENUE #200
City RIVERDALE
State MD
ZIP 20737
Phone 410 290-6677
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/17/2024
Certificate Expiration Date 11/16/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. FARZIN RASHTI

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