21D0220372 CLIA NUMBER - CHESTERTOWN PEDIATRICS CHESTERTOWN FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 21D0220372
  • Facility Name: CHESTERTOWN PEDIATRICS CHESTERTOWN FAMILY PRACTICE
  • Facility Address: 100 BROWN STREET/MEDICAL BUILDING
    CHESTERTOWN, MD
    ZIP 21620
  • Facility Phone: 410 778-1420
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FREDDY O. ARAUJO VIDAL MD
  • NPI Number: 1922120898
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 21D0220372
LAB Type Physician Office
Facility Name CHESTERTOWN PEDIATRICS CHESTERTOWN FAMILY PRACTICE
Street 100 BROWN STREET/MEDICAL BUILDING
City CHESTERTOWN
State MD
ZIP 21620
Phone 410 778-1420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2024
Certificate Expiration Date 2/26/2026
Facility Type Physician Office
Lab Director FREDDY O. ARAUJO VIDAL MD

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