21D0679845 CLIA NUMBER - DRS GOUEL AND BLOTNY

Laboratory Demographics

  • CLIA Code: 21D0679845
  • Facility Name: DRS GOUEL AND BLOTNY
  • Facility Address: 1205 YORK RD #18
    LUTHERVILLE, MD
    ZIP 21093
  • Facility Phone: 410 583-6800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELIAS G. GOUEL MD
  • NPI Number: 1063603447
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D0679845
LAB Type Physician Office
Facility Name DRS GOUEL AND BLOTNY
Street 1205 YORK RD #18
City LUTHERVILLE
State MD
ZIP 21093
Phone 410 583-6800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2024
Certificate Expiration Date 4/30/2026
Facility Type Physician Office
Lab Director ELIAS G. GOUEL MD

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