21D2277654 CLIA NUMBER - EXPRESSCARE OF ELLICOTT CITY

Laboratory Demographics

  • CLIA Code: 21D2277654
  • Facility Name: EXPRESSCARE OF ELLICOTT CITY
  • Facility Address: 4900 BEAVER RUN COURT
    ELLICOTT CITY, MD
    ZIP 21043
  • Facility Phone: 302 233-6237
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: SITTA GOMBEH-ALIE
  • NPI Number: 1922719541
  • Taxonomy: 261QU0200X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2277654
LAB Type Community Clinic
Facility Name EXPRESSCARE OF ELLICOTT CITY
Street 4900 BEAVER RUN COURT
City ELLICOTT CITY
State MD
ZIP 21043
Phone 302 233-6237
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2025
Certificate Expiration Date 3/1/2027
Facility Type Community Clinic
Lab Director SITTA GOMBEH-ALIE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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