21D2318435 CLIA NUMBER - UTOPIA MEDICAL LLC

Laboratory Demographics

  • CLIA Code: 21D2318435
  • Facility Name: UTOPIA MEDICAL LLC
  • Facility Address: 14503 MAIN STREET SUITE A
    UPPER MARLBORO, MD
    ZIP 20772
  • Facility Phone: 240 774-2880
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: REBECCA NGASSA
  • NPI Number: 1720804347
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2318435
LAB Type Practitioner Other
Facility Name UTOPIA MEDICAL LLC
Street 14503 MAIN STREET SUITE A
City UPPER MARLBORO
State MD
ZIP 20772
Phone 240 774-2880
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 REBECCA NGASSA

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