21D2311886 CLIA NUMBER - COLUMBIA DIRECT PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 21D2311886
  • Facility Name: COLUMBIA DIRECT PRIMARY CARE
  • Facility Address: 8600 SNOWDEN RIVER PARKWAY SUITE 307
    COLUMBIA, MD
    ZIP 21045
  • Facility Phone: (410) 290-0015
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: REYNALDO LEE-LLACER II
  • NPI Number: 1558406017
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 21D2311886
LAB Type Physician Office
Facility Name COLUMBIA DIRECT PRIMARY CARE
Street 8600 SNOWDEN RIVER PARKWAY SUITE 307
City COLUMBIA
State MD
ZIP 21045
Phone 4102900015
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2024
Certificate Expiration Date 9/30/2026
Facility Type Physician Office
Lab Director REYNALDO LEE-LLACER II

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This page was last updated on: 5/18/2026