21D0219041 CLIA NUMBER - SPRING GROVE HOSPITAL CENTER

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Laboratory Demographics

CLIA Number: 21D0219041

Facility Name: SPRING GROVE HOSPITAL CENTER

Facility Address:
55 WADE AVENUE - SMITH BLDG LAB SGHC
CATONSVILLE, MD
ZIP 21228
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Facility Phone Number: 410 402-7880

Facility Type: Hospital

Certificate Type: Waiver

NPI Number: 1225014244

Taxonomy: 281P00000X - Chronic Disease Hospital
(1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alteration; requires special training of the patient for rehabilitation; and/or may be expected to require a long period of supervision or care. In addition, patients require the safety, security, and shelter of these specialized inpatient or partial hospitalization settings. (2) A hospital that provides medical and skilled nursing services to patients with long-term illnesses who are not in an acute phase but who require an intensity of services not available in nursing homes.

CLIA Record

Field Name	Field Value
CLIA Number	21D0219041
LAB Type	Hospital
Facility Name	SPRING GROVE HOSPITAL CENTER
Street	55 WADE AVENUE - SMITH BLDG LAB SGHC
City	CATONSVILLE
State	MD
ZIP	21228
Phone	410 402-7880
CertificateType	4
CertificateEffectiveDate	10/2/2023
CertificateExpirationDate	10/1/2025
FacilityType	Waiver

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