21D0215195 CLIA NUMBER - CITIZENS NURSING HOME

Laboratory Demographics

  • CLIA Code: 21D0215195
  • Facility Name: CITIZENS NURSING HOME
  • Facility Address: 415 S MARKET ST
    HAVRE DE GRACE, MD
    ZIP 21078
  • Facility Phone: 301 234-4879
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: HI SIM MD
  • NPI Number: 1558318048
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D0215195
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CITIZENS NURSING HOME
Street 415 S MARKET ST
City HAVRE DE GRACE
State MD
ZIP 21078
Phone 301 234-4879
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director HI SIM MD

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