MYPOTENTIAL CLINIC - ROCKVILLE LLC
NPI 1497295406
Clinic/Center in Rockville, MD
- Organization
- Clinic/Center
- CLIA Number: 21D2130619
- CLIA Cert. Type: Other - RETIREMENT COMMUNITY
- CLIA Exp. Date: 05-14-2027
About MYPOTENTIAL CLINIC - ROCKVILLE LLC
This page provides the complete NPI Profile along with additional information for Mypotential Clinic - Rockville Llc, a provider established in Rockville, Maryland operating as a Clinic/center. The healthcare provider is registered in the NPI registry with number 1497295406 assigned on February 2017. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 8 years ago. The authorized official of this NPI record is Richard M Mazza (Chief Financial Officer)
- NPI
- 1497295406 Verify this NPI
- Provider Name
- MYPOTENTIAL CLINIC - ROCKVILLE LLC
- Entity Type
- Organization
- Location Address
- 9701 VEIRS DR ROCKVILLE, MD 20850
- Location Phone
- (301) 424-9560
- Mailing Address
- 2301 RESEARCH BLVD SUITE 310 ROCKVILLE, MD 20850
- Mailing Phone
- (301) 354-2710
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 02-24-2017
- Last Update Date
- 07-11-2018
- 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
- Taxonomy Code
- 261Q00000X
- Type
- Ambulatory Health Care Facilities
- Taxonomy Description
- A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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
- 21D2130619
- Facility Type
- Other - RETIREMENT COMMUNITY
- Certificate Effective Date
- May 15, 2025
- Certificate Expiration Date
- May 14, 2027
- Laboratory Director
- DR. NADER TAVAKOLI-JALLI
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Mypotential Clinic - Rockville Llc 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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Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
ROCKVILLE, MD 20850
ROCKVILLE, MD 20850
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1497295406, enumerated as an "organization" on February 24, 2017.
The provider is located at 9701 VEIRS DR ROCKVILLE, MD 20850 and the phone number is (301) 424-9560.
Clinic/Center with taxonomy code 261Q00000X.
