21D2302321 CLIA NUMBER - PARK PLACE PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 21D2302321
  • Facility Name: PARK PLACE PRIMARY CARE
  • Facility Address: 601 7TH ST #204
    LAUREL, MD
    ZIP 20707
  • Facility Phone: 301 776-6121
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. GABRIEL O. OBIADI
  • NPI Number: 1750632477
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D2302321
LAB Type Physician Office
Facility Name PARK PLACE PRIMARY CARE
Street 601 7TH ST #204
City LAUREL
State MD
ZIP 20707
Phone 301 776-6121
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2024
Certificate Expiration Date 4/8/2026
Facility Type Physician Office
Lab Director DR. GABRIEL O. OBIADI

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