21D2303239 CLIA NUMBER - TRINITY HEALTH PACE MONTGOMERY COUNTY

Laboratory Demographics

CLIA Code: 21D2303239
Facility Name: TRINITY HEALTH PACE MONTGOMERY COUNTY
Facility Address: 200 PERRY PARKWAY SUITE 1
GAITHERSBURG, MD
ZIP 20877
Facility Phone: 240 353-3635
Facility Type: Other - ADULT MEDICAL DAY CARE
Facility Type: Waiver
Lab Director: KATHLEEN WILLIAMS
NPI Number: 1750127478
Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

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CLIA Record

Field Name	Field Value
CLIA Number	21D2303239
LAB Type	Other - ADULT MEDICAL DAY CARE
Facility Name	TRINITY HEALTH PACE MONTGOMERY COUNTY
Street	200 PERRY PARKWAY SUITE 1
City	GAITHERSBURG
State	MD
ZIP	20877
Phone	240 353-3635
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	4/23/2024
Certificate Expiration Date	4/22/2026
Facility Type	Other - ADULT MEDICAL DAY CARE
Lab Director	KATHLEEN WILLIAMS

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