CLIA lab
CLIA 21D0686463: Poolesville Family Practice
Poolesville, MD. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 21D0686463 belongs to Poolesville Family Practice in Poolesville, MD.
Certificate of Waiver, effective July 18, 2026, expires July 17, 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
- July 18, 2026
- Certificate expiration
- July 17, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- September 1, 1992
- 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
- 21D0686463
- Lab name
- Poolesville Family Practice
- Address
- 19710 Fisher Avenue Ste J, Poolesville, MD 20837
- Phone
- (301) 972-7600
- Fax
- (301) 972-8006
Annual test volume the lab reported
- Waived tests
- 2,200
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Poolesville, MD
Related
Questions
What is the CLIA number for Poolesville Family Practice in Poolesville?
21D0686463, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Poolesville Family Practice hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 21D0686463 expire?
The CMS file lists July 17, 2028 as the certificate expiration date; the certificate took effect July 18, 2026.