21D2308887 CLIA NUMBER - FREDERICK PRIMARY CARE & SPORTS MEDICINE

Laboratory Demographics

  • CLIA Code: 21D2308887
  • Facility Name: FREDERICK PRIMARY CARE & SPORTS MEDICINE
  • Facility Address: 801 TOLLL HOUSE AVE UNIT D3
    FREDERICK, MD
    ZIP 21701
  • Facility Phone: 240 772-5775
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIKRAM SODHI
  • NPI Number: 1144226945
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2308887
LAB Type Physician Office
Facility Name FREDERICK PRIMARY CARE & SPORTS MEDICINE
Street 801 TOLLL HOUSE AVE UNIT D3
City FREDERICK
State MD
ZIP 21701
Phone 240 772-5775
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2024
Certificate Expiration Date 8/5/2026
Facility Type Physician Office
Lab Director VIKRAM SODHI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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