08D2087944 CLIA NUMBER - TIDALHEALTH IMMEDIATE CARE-LAUREL

Laboratory Demographics

  • CLIA Code: 08D2087944
  • Facility Name: TIDALHEALTH IMMEDIATE CARE-LAUREL
  • Facility Address: 30549 SUSSEX HIGHWAY
    LAUREL, DE
    ZIP 19956
  • Facility Phone: 302 297-2579
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JENNIFER B. KETTERMAN
  • NPI Number: 1205649514
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 08D2087944
LAB Type Physician Office
Facility Name TIDALHEALTH IMMEDIATE CARE-LAUREL
Street 30549 SUSSEX HIGHWAY
City LAUREL
State DE
ZIP 19956
Phone 302 297-2579
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2024
Certificate Expiration Date 12/8/2026
Facility Type Physician Office
Lab Director JENNIFER B. KETTERMAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 9/29/2025