21D1019521 CLIA NUMBER - COLUMBIA MD ORTHO/HICKORY RIDGE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 21D1019521
  • Facility Name: COLUMBIA MD ORTHO/HICKORY RIDGE SURGERY CENTER
  • Facility Address: 10700 CHARTER DR STE 301
    COLUMBIA, MD
    ZIP 21044
  • Facility Phone: 410 910-2301
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DANIEL TANG
  • NPI Number: 1649393695
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D1019521
LAB Type Ambulatory Surgery Center
Facility Name COLUMBIA MD ORTHO/HICKORY RIDGE SURGERY CENTER
Street 10700 CHARTER DR STE 301
City COLUMBIA
State MD
ZIP 21044
Phone 410 910-2301
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2023
Certificate Expiration Date 11/19/2025
Facility Type Ambulatory Surgery Center
Lab Director DANIEL TANG

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