21D1017002 CLIA NUMBER - BAY PEDIATRIC CENTER LLC,THE

Laboratory Demographics

  • CLIA Code: 21D1017002
  • Facility Name: BAY PEDIATRIC CENTER LLC,THE
  • Facility Address: 606 DUTCHMAN'S LANE
    EASTON, MD
    ZIP 21601
  • Facility Phone: 410 763-8272
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DENISE D. KYLE
  • NPI Number: 1730204827
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D1017002
LAB Type Physician Office
Facility Name BAY PEDIATRIC CENTER LLC,THE
Street 606 DUTCHMAN'S LANE
City EASTON
State MD
ZIP 21601
Phone 410 763-8272
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2025
Certificate Expiration Date 1/3/2027
Facility Type Physician Office
Lab Director DENISE D. KYLE

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