21D0219659 CLIA NUMBER - PATHOLOGY ASSOCIATES LABORATORIES PC

Laboratory Demographics

  • CLIA Code: 21D0219659
  • Facility Name: PATHOLOGY ASSOCIATES LABORATORIES PC
  • Facility Address: 5601 LOCH RAVEN BLVD POB STE 102
    BALTIMORE, MD
    ZIP 21239
  • Facility Phone: 443 444-4178
  • Facility Type: Independent
  • Facility Type: Certificate of Compliance
  • Lab Director: MOIRA P. LARSEN
  • NPI Number: 1356568059
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 21D0219659
LAB Type Independent
Facility Name PATHOLOGY ASSOCIATES LABORATORIES PC
Street 5601 LOCH RAVEN BLVD POB STE 102
City BALTIMORE
State MD
ZIP 21239
Phone 443 444-4178
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 3/26/2024
Certificate Expiration Date 3/25/2026
Facility Type Independent
Lab Director MOIRA P. LARSEN

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