21D1010522 CLIA NUMBER - PIKESVILLE DIALYSIS

Laboratory Demographics

  • CLIA Code: 21D1010522
  • Facility Name: PIKESVILLE DIALYSIS
  • Facility Address: 6609 REISTERTOWN ROAD STE 100 STE 220
    BALTIMORE, MD
    ZIP 21215
  • Facility Phone: 410 358-1745
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: IBIKUNLE O. KOYA MD
  • NPI Number: 1588088694
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D1010522
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name PIKESVILLE DIALYSIS
Street 6609 REISTERTOWN ROAD STE 100 STE 220
City BALTIMORE
State MD
ZIP 21215
Phone 410 358-1745
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2025
Certificate Expiration Date 3/16/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director IBIKUNLE O. KOYA MD

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