CLIA lab
CLIA 21D0963328: Ettienne's Premier Pediatric Care LLC
Bowie, MD. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 21D0963328 belongs to Ettienne's Premier Pediatric Care LLC in Bowie, MD.
Certificate of Waiver, effective July 27, 2025, expires July 26, 2027.
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 27, 2025
- Certificate expiration
- July 26, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- July 27, 1999
- 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
- 21D0963328
- Lab name
- Ettienne's Premier Pediatric Care LLC
- Address
- 2905 Mitchellville Road Suite 115, Bowie, MD 20716
- Phone
- (301) 390-7960
Annual test volume the lab reported
- Waived tests
- 1,500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Annapath, IncCertificate of Compliance, Independent21D1057101
- Anne Arundel Urology PACertificate of Waiver, Physician office21D2115933
- Apex Stat Labs LLCCertificate of Registration, Independent21D2344116
- Asthma & Allergy Center LLCCertificate of Waiver, Physician office21D2304436
- Bowie Assisted Living IncCertificate of Waiver, Assisted living facility21D2237391
Related
Questions
What is the CLIA number for Ettienne's Premier Pediatric Care LLC in Bowie?
21D0963328, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Ettienne's Premier Pediatric Care LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 21D0963328 expire?
The CMS file lists July 26, 2027 as the certificate expiration date; the certificate took effect July 27, 2025.