21D0945271 CLIA NUMBER - EVERGREEN ADULT MEDICAL DAY SERVICES

Laboratory Demographics

  • CLIA Code: 21D0945271
  • Facility Name: EVERGREEN ADULT MEDICAL DAY SERVICES
  • Facility Address: 1 BALTIMORE STREET
    CUMBERLAND, MD
    ZIP 21502
  • Facility Phone: 301 777-2650
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: VELUPPILLAS NAGULENDRAN
  • NPI Number: 1144420597
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D0945271
LAB Type Other
Facility Name EVERGREEN ADULT MEDICAL DAY SERVICES
Street 1 BALTIMORE STREET
City CUMBERLAND
State MD
ZIP 21502
Phone 301 777-2650
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2024
Certificate Expiration Date 4/27/2026
Facility Type Other
Lab Director VELUPPILLAS NAGULENDRAN

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