PREMISE HEALTH OF MARYLAND MEDICAL P C
NPI 1043105224
Clinic/Center - Multi-Specialty in Frederick, MD
- Organization
- Clinic/Center
- Multi-Specialty
- CLIA Number: 21D2130748
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 05-16-2027
About PREMISE HEALTH OF MARYLAND MEDICAL P C
This page provides the complete NPI Profile along with additional information for Premise Health Of Maryland Medical P C, a provider established in Frederick, Maryland operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1043105224 assigned on June 2025. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated March 2026. The authorized official of this NPI record is Edward William Schwartz (President)
- NPI
- 1043105224 Verify this NPI
- Provider Name
- PREMISE HEALTH OF MARYLAND MEDICAL P C
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 633 RESEARCH DR FREDERICK, MD 21703
- Location Phone
- (301) 662-1657
- Mailing Address
- 5500 MARYLAND WAY STE 120 BRENTWOOD, TN 37027
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-10-2025
- Last Update Date
- 03-04-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Multi-Specialty
- Taxonomy Code
- 261QM1300X
- Type
- Ambulatory Health Care Facilities
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 21D2130748
- Facility Type
- Physician Office
- Certificate Effective Date
- May 17, 2025
- Certificate Expiration Date
- May 16, 2027
- Laboratory Director
- JOHN CLARKE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Premise Health Of Maryland Medical P C to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043105224, enumerated as an "organization" on June 10, 2025.
The provider is located at 633 RESEARCH DR FREDERICK, MD 21703 and the phone number is (301) 662-1657.
Clinic/Center with taxonomy code 261QM1300X and a focus in Multi-Specialty.
