21D0708307 CLIA NUMBER - KAISER PERMANENTE WOODLAWN CLINICAL

Laboratory Demographics

  • CLIA Code: 21D0708307
  • Facility Name: KAISER PERMANENTE WOODLAWN CLINICAL
  • Facility Address: 7141 SECURITY BOULEVARD
    BALTIMORE, MD
    ZIP 21244
  • Facility Phone: 410 281-6000
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Microscopy
  • Lab Director: DR. RICHELLE S. GASKIN
  • NPI Number: 1831411628
  • Taxonomy: 3336H0001X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 21D0708307
LAB Type Ancillary Testing Site in Health Care Center
Facility Name KAISER PERMANENTE WOODLAWN CLINICAL
Street 7141 SECURITY BOULEVARD
City BALTIMORE
State MD
ZIP 21244
Phone 410 281-6000
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director DR. RICHELLE S. GASKIN

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This page was last updated on: 6/4/2025