21D0678784 CLIA NUMBER - AUTUMN LAKE HEALTHCARE AT RUXTON

Laboratory Demographics

  • CLIA Code: 21D0678784
  • Facility Name: AUTUMN LAKE HEALTHCARE AT RUXTON
  • Facility Address: 7001 N CHARLES ST
    TOWSON, MD
    ZIP 21204
  • Facility Phone: 410 821-9600
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DR. SUNNIYA KHAN
  • NPI Number: 1568419174
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 21D0678784
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AUTUMN LAKE HEALTHCARE AT RUXTON
Street 7001 N CHARLES ST
City TOWSON
State MD
ZIP 21204
Phone 410 821-9600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DR. SUNNIYA KHAN

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