21D0218398 CLIA NUMBER - AUTUMN LAKE HEALTHCARE AT RIVERVIEW

Laboratory Demographics

  • CLIA Code: 21D0218398
  • Facility Name: AUTUMN LAKE HEALTHCARE AT RIVERVIEW
  • Facility Address: 1 EASTERN BLVD
    ESSEX, MD
    ZIP 21221
  • Facility Phone: 410 574-1400
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: NARENDER BHARAJ
  • NPI Number: 1558921759
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 21D0218398
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AUTUMN LAKE HEALTHCARE AT RIVERVIEW
Street 1 EASTERN BLVD
City ESSEX
State MD
ZIP 21221
Phone 410 574-1400
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 NARENDER BHARAJ

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