21D0864480 CLIA NUMBER - LASER SURGERY CENTER INC

Laboratory Demographics

  • CLIA Code: 21D0864480
  • Facility Name: LASER SURGERY CENTER INC
  • Facility Address: 484 RITCHIE HWY
    SEVERNA PARK, MD
    ZIP 21146
  • Facility Phone: 410 544-4600
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ROSS J. VAN ANTWERP
  • NPI Number: 1487889531
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D0864480
LAB Type Ambulatory Surgery Center
Facility Name LASER SURGERY CENTER INC
Street 484 RITCHIE HWY
City SEVERNA PARK
State MD
ZIP 21146
Phone 410 544-4600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2024
Certificate Expiration Date 10/2/2026
Facility Type Ambulatory Surgery Center
Lab Director ROSS J. VAN ANTWERP

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