21D2298650 CLIA NUMBER - GIFTED PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 21D2298650
  • Facility Name: GIFTED PRIMARY CARE LLC
  • Facility Address: 3060 MITCHELLVILLE RD #106A
    BOWIE, MD
    ZIP 20716
  • Facility Phone: 301 357-1167
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NYEDIANG ATEGHANG
  • NPI Number: 1689399032
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2298650
LAB Type Physician Office
Facility Name GIFTED PRIMARY CARE LLC
Street 3060 MITCHELLVILLE RD #106A
City BOWIE
State MD
ZIP 20716
Phone 301 357-1167
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2024
Certificate Expiration Date 2/5/2026
Facility Type Physician Office
Lab Director NYEDIANG ATEGHANG

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