21D0952978 CLIA NUMBER - ATLANTIC GENERAL HEALTH SYSTEM

Laboratory Demographics

CLIA Number: 21D0952978

Facility Name: ATLANTIC GENERAL HEALTH SYSTEM

Facility Address:
11107 RACETRACK ROAD
BERLIN, MD
ZIP 21811
Get Directions

Facility Phone Number: 410 641-9362

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1518199223

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	21D0952978
LAB Type	Physician Office
Facility Name	ATLANTIC GENERAL HEALTH SYSTEM
Street	11107 RACETRACK ROAD
City	BERLIN
State	MD
ZIP	21811
Phone	410 641-9362
CertificateType	4
CertificateEffectiveDate	7/24/2023
CertificateExpirationDate	7/23/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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