21D0221165 CLIA NUMBER - TIDALHEALTH CARDIOLOGY

Laboratory Demographics

CLIA Number: 21D0221165

Facility Name: TIDALHEALTH CARDIOLOGY

Facility Address:
400 EASTERN SHORE DRIVE
SALISBURY, MD
ZIP 21804
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Facility Phone Number: 410 749-8906

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1245855196

Taxonomy: 207RE0101X - Internal Medicine
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

CLIA Record

Field Name	Field Value
CLIA Number	21D0221165
LAB Type	Physician Office
Facility Name	TIDALHEALTH CARDIOLOGY
Street	400 EASTERN SHORE DRIVE
City	SALISBURY
State	MD
ZIP	21804
Phone	410 749-8906
CertificateType	4
CertificateEffectiveDate	1/28/2023
CertificateExpirationDate	1/27/2025
FacilityType	Waiver

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