21D0684816 CLIA NUMBER - LIFEBRIDGE COMM PEDIATRICS DBA MAIN ST PEDIATRICS

Laboratory Demographics

  • CLIA Code: 21D0684816
  • Facility Name: LIFEBRIDGE COMM PEDIATRICS DBA MAIN ST PEDIATRICS
  • Facility Address: 849 FAIRMOUNT AVE SUITE 100A
    TOWSON, MD
    ZIP 21286
  • Facility Phone: 410 494-1369
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DEBORAH G. BITTAR
  • NPI Number: 1629495528
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D0684816
LAB Type Physician Office
Facility Name LIFEBRIDGE COMM PEDIATRICS DBA MAIN ST PEDIATRICS
Street 849 FAIRMOUNT AVE SUITE 100A
City TOWSON
State MD
ZIP 21286
Phone 410 494-1369
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2025
Certificate Expiration Date 9/30/2027
Facility Type Physician Office
Lab Director DR. DEBORAH G. BITTAR

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