21D2292933 CLIA NUMBER - DIVINE CARE SERVICES LLC

Laboratory Demographics

  • CLIA Code: 21D2292933
  • Facility Name: DIVINE CARE SERVICES LLC
  • Facility Address: 30 COURTHHOUSE SQ SUITE G1
    ROCKVILLE, MD
    ZIP 20850
  • Facility Phone: 301 966-7610
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: NKECHI ILEKA-ADEOYE
  • NPI Number: 1225613656
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2292933
LAB Type Practitioner Other
Facility Name DIVINE CARE SERVICES LLC
Street 30 COURTHHOUSE SQ SUITE G1
City ROCKVILLE
State MD
ZIP 20850
Phone 301 966-7610
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Practitioner Other
Lab Director NKECHI ILEKA-ADEOYE

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