21D2314761 CLIA NUMBER - ASC DEVELOPMENT COMPANY, LLC

Laboratory Demographics

  • CLIA Code: 21D2314761
  • Facility Name: ASC DEVELOPMENT COMPANY, LLC
  • Facility Address: 19735 GERMANTOWN RD #360
    GERMANTOWN, MD
    ZIP 20874
  • Facility Phone: 301 528-2810
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. DONTESE J. NICHOLSON
  • NPI Number: 1518208883
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2314761
LAB Type Ambulatory Surgery Center
Facility Name ASC DEVELOPMENT COMPANY, LLC
Street 19735 GERMANTOWN RD #360
City GERMANTOWN
State MD
ZIP 20874
Phone 301 528-2810
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/26/2024
Certificate Expiration Date 11/25/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. DONTESE J. NICHOLSON

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This page was last updated on: 3/20/2025