21D2322156 CLIA NUMBER - BLOSSOMING MINDS PEDIATRICS

Laboratory Demographics

  • CLIA Code: 21D2322156
  • Facility Name: BLOSSOMING MINDS PEDIATRICS
  • Facility Address: 13994 BALTIMORE AVE SUITE 101
    LAUREL, MD
    ZIP 20707
  • Facility Phone: 410 656-4775
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEYVAN RAFEI
  • NPI Number: 1558173559
  • Taxonomy: 261QM2500X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2322156
LAB Type Physician Office
Facility Name BLOSSOMING MINDS PEDIATRICS
Street 13994 BALTIMORE AVE SUITE 101
City LAUREL
State MD
ZIP 20707
Phone 410 656-4775
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Physician Office
Lab Director KEYVAN RAFEI

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