21D0694809 CLIA NUMBER - AUTUMN RIDGE AT NORTH OAKS

Laboratory Demographics

  • CLIA Code: 21D0694809
  • Facility Name: AUTUMN RIDGE AT NORTH OAKS
  • Facility Address: 725 MT WILSON LANE
    BALTIMORE, MD
    ZIP 21208
  • Facility Phone: 410 484-7300
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JEFFREY K. ZIBELL
  • NPI Number: 1215911961
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 21D0694809
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AUTUMN RIDGE AT NORTH OAKS
Street 725 MT WILSON LANE
City BALTIMORE
State MD
ZIP 21208
Phone 410 484-7300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2024
Certificate Expiration Date 7/9/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JEFFREY K. ZIBELL

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