08D2211967 CLIA NUMBER - EASTERSEALS DE & MARLAND'S EASTERN SHORE

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Laboratory Demographics

CLIA Number: 08D2211967

Facility Name: EASTERSEALS DE & MARLAND'S EASTERN SHORE

Facility Address:
61 CORPORATE CIRCLE
NEW CASTLE, DE
ZIP 19720
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Facility Phone Number: 302 324-4444

Facility Type: Other - HOME & COMMUNITY BASED CN

Certificate Type: Waiver

NPI Number: 1437156635

Taxonomy: 103TM1800X - Psychologist

CLIA Record

Field Name	Field Value
CLIA Number	08D2211967
LAB Type	Other - HOME & COMMUNITY BASED CN
Facility Name	EASTERSEALS DE & MARLAND'S EASTERN SHORE
Street	61 CORPORATE CIRCLE
City	NEW CASTLE
State	DE
ZIP	19720
Phone	302 324-4444
CertificateType	4
CertificateEffectiveDate	2/2/2023
CertificateExpirationDate	2/1/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024