21D2272610 CLIA NUMBER - NP FAMILY PRACTICE/CLINIC

Laboratory Demographics

  • CLIA Code: 21D2272610
  • Facility Name: NP FAMILY PRACTICE/CLINIC
  • Facility Address: 22680 CEDAR LANE COURT
    LEONARDTOWN, MD
    ZIP 20650
  • Facility Phone: 301 997-4453
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: TEMERIA WILCOX
  • NPI Number: 1710543665
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2272610
LAB Type Practitioner Other
Facility Name NP FAMILY PRACTICE/CLINIC
Street 22680 CEDAR LANE COURT
City LEONARDTOWN
State MD
ZIP 20650
Phone 301 997-4453
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/23/2024
Certificate Expiration Date 11/22/2026
Facility Type Practitioner Other
Lab Director TEMERIA WILCOX

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