21D2309367 CLIA NUMBER - CLINIVA PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 21D2309367
  • Facility Name: CLINIVA PRIMARY CARE LLC
  • Facility Address: 5999 HARPERS FARM RD #W230
    COLUMBIA, MD
    ZIP 21044
  • Facility Phone: 240 931-0658
  • Facility Type: Other - DIANOSTIC TESTING
  • Facility Type: Waiver
  • Lab Director: ADEJOKE SIJUWADE
  • NPI Number: 1689402679
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2309367
LAB Type Other - DIANOSTIC TESTING
Facility Name CLINIVA PRIMARY CARE LLC
Street 5999 HARPERS FARM RD #W230
City COLUMBIA
State MD
ZIP 21044
Phone 240 931-0658
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2024
Certificate Expiration Date 8/13/2026
Facility Type Other - DIANOSTIC TESTING
Lab Director ADEJOKE SIJUWADE

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