21D0889330 CLIA NUMBER - AUTUMN LAKE HEALTHCARE OF PIKESVILLE

Laboratory Demographics

  • CLIA Code: 21D0889330
  • Facility Name: AUTUMN LAKE HEALTHCARE OF PIKESVILLE
  • Facility Address: 7 SUDBROOK LANE
    PIKESVILLE, MD
    ZIP 21208
  • Facility Phone: 410 657-2900
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ANDRES SALAZAR
  • NPI Number: 1811489511
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 21D0889330
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name AUTUMN LAKE HEALTHCARE OF PIKESVILLE
Street 7 SUDBROOK LANE
City PIKESVILLE
State MD
ZIP 21208
Phone 410 657-2900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/26/2024
Certificate Expiration Date 7/25/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ANDRES SALAZAR

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