21D0987072 CLIA NUMBER - LOCH RAVEN VAMC

Laboratory Demographics

  • CLIA Code: 21D0987072
  • Facility Name: LOCH RAVEN VAMC
  • Facility Address: 3901 ALAMEDA AVE
    BALTIMORE, MD
    ZIP 21218
  • Facility Phone: 410 605-7650
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: DONG LEE
  • NPI Number: 1639475809
  • Taxonomy: 273Y00000X - Rehabilitation Unit

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CLIA Record

Field Name Field Value
CLIA Number 21D0987072
LAB Type Community Clinic
Facility Name LOCH RAVEN VAMC
Street 3901 ALAMEDA AVE
City BALTIMORE
State MD
ZIP 21218
Phone 410 605-7650
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 5/29/2001
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director DONG LEE

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