21D2310739 CLIA NUMBER - EMPOWER PEDIATRICS

Laboratory Demographics

  • CLIA Code: 21D2310739
  • Facility Name: EMPOWER PEDIATRICS
  • Facility Address: 14113 BALTIMORE AVE
    LAUREL, MD
    ZIP 20707
  • Facility Phone: 443 574-6405
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: COLLEEN WALLACE
  • NPI Number: 1194426361
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D2310739
LAB Type Physician Office
Facility Name EMPOWER PEDIATRICS
Street 14113 BALTIMORE AVE
City LAUREL
State MD
ZIP 20707
Phone 443 574-6405
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2024
Certificate Expiration Date 9/9/2026
Facility Type Physician Office
Lab Director COLLEEN WALLACE

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