21D0930967 CLIA NUMBER - ROBERT M COOPER MD

Laboratory Demographics

  • CLIA Code: 21D0930967
  • Facility Name: ROBERT M COOPER MD
  • Facility Address: 6503 PARK HEIGHTS AVENUE
    BALTIMORE, MD
    ZIP 21215
  • Facility Phone: 410 358-2397
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT M. COOPER MD
  • NPI Number: 1235159898
  • Taxonomy: 207RG0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D0930967
LAB Type Physician Office
Facility Name ROBERT M COOPER MD
Street 6503 PARK HEIGHTS AVENUE
City BALTIMORE
State MD
ZIP 21215
Phone 410 358-2397
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Physician Office
Lab Director ROBERT M. COOPER MD

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