21D2318428 CLIA NUMBER - ADVANCED TELECLINIC

Laboratory Demographics

  • CLIA Code: 21D2318428
  • Facility Name: ADVANCED TELECLINIC
  • Facility Address: 9420 ANNAPOLIS RD SUITE 213
    LANHAM, MD
    ZIP 20706
  • Facility Phone: 240 930-7466
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: BANIS GITHINJI
  • NPI Number: 1902594179
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2318428
LAB Type Practitioner Other
Facility Name ADVANCED TELECLINIC
Street 9420 ANNAPOLIS RD SUITE 213
City LANHAM
State MD
ZIP 20706
Phone 240 930-7466
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/11/2025
Certificate Expiration Date 2/10/2027
Facility Type Practitioner Other
Lab Director BANIS GITHINJI

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