21D0948895 CLIA NUMBER - RUXTON SURGICENTER LLC

Laboratory Demographics

  • CLIA Code: 21D0948895
  • Facility Name: RUXTON SURGICENTER LLC
  • Facility Address: 8322 BELLONA AVENUE SUITE 201
    BALTIMORE, MD
    ZIP 21204
  • Facility Phone: 410 337-7900
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: BRUCE S. WOLOCK MD
  • NPI Number: 1841347143
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D0948895
LAB Type Ambulatory Surgery Center
Facility Name RUXTON SURGICENTER LLC
Street 8322 BELLONA AVENUE SUITE 201
City BALTIMORE
State MD
ZIP 21204
Phone 410 337-7900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2024
Certificate Expiration Date 7/20/2026
Facility Type Ambulatory Surgery Center
Lab Director BRUCE S. WOLOCK MD

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