21D0220927 CLIA NUMBER - LIFEBRIDGE PRIMARY CARE OF ELDERSBURG

Laboratory Demographics

  • CLIA Code: 21D0220927
  • Facility Name: LIFEBRIDGE PRIMARY CARE OF ELDERSBURG
  • Facility Address: 1645 LIBERTY RD
    ELDERSBURG, MD
    ZIP 21784
  • Facility Phone: 410 795-7737
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELLIS MEZ
  • NPI Number: 1902161847
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D0220927
LAB Type Physician Office
Facility Name LIFEBRIDGE PRIMARY CARE OF ELDERSBURG
Street 1645 LIBERTY RD
City ELDERSBURG
State MD
ZIP 21784
Phone 410 795-7737
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Physician Office
Lab Director ELLIS MEZ

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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