CLIA lab
CLIA 21D2130748: Premise Health of Maryland Medical PC
Frederick, MD. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 21D2130748 belongs to Premise Health of Maryland Medical PC in Frederick, MD.
Certificate of Waiver, effective May 17, 2025, expires May 16, 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
- May 17, 2025
- Certificate expiration
- May 16, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- May 17, 2017
- 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
- 21D2130748
- Lab name
- Premise Health of Maryland Medical PC
- Address
- 633 Research Court, Frederick, MD 21703
- Phone
- (301) 662-1657
- Fax
- (301) 620-2903
Annual test volume the lab reported
- Waived tests
- 50
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 Premise Health of Maryland Medical PC in Frederick?
21D2130748, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Premise Health of Maryland Medical PC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 21D2130748 expire?
The CMS file lists May 16, 2027 as the certificate expiration date; the certificate took effect May 17, 2025.