21D2311512 CLIA NUMBER - COMPREHENSIVE PEDIATRIC CARE LLC

Laboratory Demographics

  • CLIA Code: 21D2311512
  • Facility Name: COMPREHENSIVE PEDIATRIC CARE LLC
  • Facility Address: 9400 LIVINGSTON RD #320
    FORT WASHINGTON, MD
    ZIP 20744
  • Facility Phone: 443 288-1288
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. RUTH M. KANTHULA
  • NPI Number: 1982459715
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D2311512
LAB Type Physician Office
Facility Name COMPREHENSIVE PEDIATRIC CARE LLC
Street 9400 LIVINGSTON RD #320
City FORT WASHINGTON
State MD
ZIP 20744
Phone 443 288-1288
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Physician Office
Lab Director DR. RUTH M. KANTHULA

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