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DIAGNOSTIC LAB OF SOUTHERN MARYLAND
NPI 1366158719
Clinic/Center - Health Service in Waldorf, MD

Active since January 30, 2023CLIA 21D2276477 · Waiver
3985 SAINT CHARLES PKWY STE 200E, WALDORF, MD 20602(240) 538-8571(240) 607-7229 Get Directions Write a Review

NPPES record last updated: January 30, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Diagnostic Lab Of Southern Maryland NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DIAGNOSTIC LAB OF SOUTHERN MARYLAND (NPI 1366158719) is a healthcare organization registered as a health service in Waldorf, Maryland and active in the NPI registry since January 2023. The organization holds a CLIA Waiver certificate valid through February 8, 2027 and lists Teaira Milburn, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1366158719
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameDIAGNOSTIC LAB OF SOUTHERN MARYLAND
Location Address3985 SAINT CHARLES PKWY STE 200EWaldorf, MD 20602-2683
Mailing Address3828 Lakewood PlWaldorf, MD 20602-1429 · (240) 538-8571 · Fax (240) 607-7229
Phone(240) 538-8571
Fax(240) 607-7229
Organization SubpartNo
Authorized OfficialTeaira MilburnOwner/provider · (240) 925-9449
Enumeration DateJanuary 30, 2023
NPPES CertifiedJanuary 29, 2023
✔ NPI 1366158719 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X
3985 SAINT CHARLES PKWY STE 200E, Waldorf, MD 20602
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2276477

Diagnostic Lab Of Southern Maryland LLC · Waldorf, MD
Active · expires Feb 8, 2027
CLIA Number21D2276477
Laboratory TypeDiagnostic Testing Lab
Certificate Effective DateFebruary 9, 2025
Certificate Expiration DateFebruary 8, 2027
Laboratory DirectorTemeria Wilcox
Laboratory Phone(240) 925-9449
Laboratory LocationDiagnostic Lab Of Southern Maryland LLC3985 St Charles Pkwy Ste 200E, Waldorf, MD 20602
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Diagnostic Lab Of Southern Maryland's NPI number?

The NPI number for Diagnostic Lab Of Southern Maryland is 1366158719. It was assigned to this organization in the NPPES registry on January 30, 2023.

Where is Diagnostic Lab Of Southern Maryland located?

Diagnostic Lab Of Southern Maryland is located at 3985 Saint Charles Pkwy Ste 200E, Waldorf, MD 20602. The listed phone number is (240) 538-8571.

What is Diagnostic Lab Of Southern Maryland's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

Does Diagnostic Lab Of Southern Maryland hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2276477) is associated with this NPI, valid through February 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Diagnostic Lab Of Southern Maryland was last updated on January 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.