21D0924537 CLIA NUMBER - CHESAPEAKE UROLOGY ASSOCIATES, LLC

Laboratory Demographics

CLIA Number: 21D0924537

Facility Name: CHESAPEAKE UROLOGY ASSOCIATES, LLC

Facility Address:
10710 CHARTER DRIVE SUITE 130
COLUMBIA, MD
ZIP 21044
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Facility Phone Number: 410 772-7000

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1265529465

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	21D0924537
LAB Type	Physician Office
Facility Name	CHESAPEAKE UROLOGY ASSOCIATES, LLC
Street	10710 CHARTER DRIVE SUITE 130
City	COLUMBIA
State	MD
ZIP	21044
Phone	410 772-7000
CertificateType	3
CertificateEffectiveDate	11/7/2022
CertificateExpirationDate	11/6/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024