21D0960753 CLIA NUMBER - FAYETTE LEASING CO LLC DBA FAYETTE HLTH & REHAB CT

Laboratory Demographics

  • CLIA Code: 21D0960753
  • Facility Name: FAYETTE LEASING CO LLC DBA FAYETTE HLTH & REHAB CT
  • Facility Address: 1217 WEST FAYETTE STREET
    BALTIMORE, MD
    ZIP 21223
  • Facility Phone: 513 530-1808
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: NARENDER BHARAJ
  • NPI Number: 1851578082
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 21D0960753
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name FAYETTE LEASING CO LLC DBA FAYETTE HLTH & REHAB CT
Street 1217 WEST FAYETTE STREET
City BALTIMORE
State MD
ZIP 21223
Phone 513 530-1808
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2025
Certificate Expiration Date 5/18/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director NARENDER BHARAJ

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