08D1054469 CLIA NUMBER - TIDALHEALTH PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 08D1054469
  • Facility Name: TIDALHEALTH PRIMARY CARE
  • Facility Address: 96 ATLANTIC AVENUE, SUITE 101
    OCEAN VIEW, DE
    ZIP 19970
  • Facility Phone: (410) 641-9362
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ELLEN J. ROWE RHODES
  • NPI Number: 1174485239
  • Taxonomy: 207RR0500X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 08D1054469
LAB Type Physician Office
Facility Name TIDALHEALTH PRIMARY CARE
Street 96 ATLANTIC AVENUE, SUITE 101
City OCEAN VIEW
State DE
ZIP 19970
Phone 4106419362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2026
Certificate Expiration Date 5/21/2028
Facility Type Physician Office
Lab Director DR. ELLEN J. ROWE RHODES

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This page was last updated on: 5/18/2026