21D2300537 CLIA NUMBER - ELITE WEIGHTLOSS & TRT

Laboratory Demographics

  • CLIA Code: 21D2300537
  • Facility Name: ELITE WEIGHTLOSS & TRT
  • Facility Address: 1604 RIDGESIDE DRIVE #B2
    MOUNT AIRY, MD
    ZIP 21771
  • Facility Phone: 410 498-7055
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: EMILIENNE N. NKEMAYIM
  • NPI Number: 1568283547
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2300537
LAB Type Practitioner Other
Facility Name ELITE WEIGHTLOSS & TRT
Street 1604 RIDGESIDE DRIVE #B2
City MOUNT AIRY
State MD
ZIP 21771
Phone 410 498-7055
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2024
Certificate Expiration Date 3/11/2026
Facility Type Practitioner Other
Lab Director EMILIENNE N. NKEMAYIM

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