CLIA lab
CLIA 21D0220530: Praveen Bolarum MD LLC
Frederick, MD. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 21D0220530 belongs to Praveen Bolarum MD LLC in Frederick, MD.
Certificate of Waiver, effective September 1, 2026, expires August 31, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- September 1, 2026
- Certificate expiration
- August 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 8, 1995
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 21D0220530
- Lab name
- Praveen Bolarum MD LLC
- Address
- 196 Thomas Johnson Drive Suite 135, Frederick, MD 21702
- Phone
- (301) 694-6688
- Fax
- (301) 694-8524
Annual test volume the lab reported
- Waived tests
- 250
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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Related
Questions
What is the CLIA number for Praveen Bolarum MD LLC in Frederick?
21D0220530, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Praveen Bolarum MD LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 21D0220530 expire?
The CMS file lists August 31, 2028 as the certificate expiration date; the certificate took effect September 1, 2026.