21D0972004 CLIA NUMBER - SHEPHERDS CLINIC

Laboratory Demographics

  • CLIA Code: 21D0972004
  • Facility Name: SHEPHERDS CLINIC
  • Facility Address: 2800 KIRK AVE
    BALTIMORE, MD
    ZIP 21218
  • Facility Phone: 410 467-7140
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: KATHLEEN B. MCHUGH MD
  • NPI Number: 1962782532
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D0972004
LAB Type Community Clinic
Facility Name SHEPHERDS CLINIC
Street 2800 KIRK AVE
City BALTIMORE
State MD
ZIP 21218
Phone 410 467-7140
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Community Clinic
Lab Director KATHLEEN B. MCHUGH MD

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