21D2317297 CLIA NUMBER - KHADEJA FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 21D2317297
  • Facility Name: KHADEJA FAMILY PRACTICE LLC
  • Facility Address: 5 HILLCREST DR #B103
    FREDERICK, MD
    ZIP 21703
  • Facility Phone: 240 439-5619
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KHADEJA Q. BAIDOO
  • NPI Number: 1255942231
  • Taxonomy: 363LF0000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2317297
LAB Type Physician Office
Facility Name KHADEJA FAMILY PRACTICE LLC
Street 5 HILLCREST DR #B103
City FREDERICK
State MD
ZIP 21703
Phone 240 439-5619
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2025
Certificate Expiration Date 1/21/2027
Facility Type Physician Office
Lab Director KHADEJA Q. BAIDOO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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