21D2292828 CLIA NUMBER - BETHESDA ENDOSCOPY CENTER

Laboratory Demographics

CLIA Number: 21D2292828

Facility Name: BETHESDA ENDOSCOPY CENTER

Facility Address:
6100 EXECUTIVE BLVD SUITE 300
ROCKVILLE, MD
ZIP 20852
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Facility Phone Number: 301 530-2800

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1316969058

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D2292828
LAB Type	Ambulatory Surgery Center
Facility Name	BETHESDA ENDOSCOPY CENTER
Street	6100 EXECUTIVE BLVD SUITE 300
City	ROCKVILLE
State	MD
ZIP	20852
Phone	301 530-2800
CertificateType	4
CertificateEffectiveDate	10/31/2023
CertificateExpirationDate	10/30/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024