21D2287040 CLIA NUMBER - ASC DEVELOPMENT COMPANY LLC

Laboratory Demographics

  • CLIA Code: 21D2287040
  • Facility Name: ASC DEVELOPMENT COMPANY LLC
  • Facility Address: 5010 REGENCY PLACE SUITE 202B
    WHITE PLAINS, MD
    ZIP 20695
  • Facility Phone: 301 433-7967
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RICHARD BROUILLETTE
  • NPI Number: 1114491073
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2287040
LAB Type Ambulatory Surgery Center
Facility Name ASC DEVELOPMENT COMPANY LLC
Street 5010 REGENCY PLACE SUITE 202B
City WHITE PLAINS
State MD
ZIP 20695
Phone 301 433-7967
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2025
Certificate Expiration Date 8/7/2027
Facility Type Ambulatory Surgery Center
Lab Director RICHARD BROUILLETTE

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