21D1008937 CLIA NUMBER - BAYSIDE INTERNAL MEDICINE LLC

Laboratory Demographics

  • CLIA Code: 21D1008937
  • Facility Name: BAYSIDE INTERNAL MEDICINE LLC
  • Facility Address: 998 HOSPITALITY WAY STE 102
    ABERDEEN, MD
    ZIP 21001
  • Facility Phone: 410 297-9500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PRASHANT R. SHUKLA
  • NPI Number: 1326227216
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D1008937
LAB Type Physician Office
Facility Name BAYSIDE INTERNAL MEDICINE LLC
Street 998 HOSPITALITY WAY STE 102
City ABERDEEN
State MD
ZIP 21001
Phone 410 297-9500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2025
Certificate Expiration Date 8/25/2027
Facility Type Physician Office
Lab Director PRASHANT R. SHUKLA

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