21D1040404 CLIA NUMBER - BAY AREA PEDIATRICS

Laboratory Demographics

  • CLIA Code: 21D1040404
  • Facility Name: BAY AREA PEDIATRICS
  • Facility Address: 165 LOG CANOE CIRCLE STE E
    STEVENSVILLE, MD
    ZIP 21666
  • Facility Phone: 410 643-1000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: D JAMES KALLIONGIS MD
  • NPI Number: 1760649958
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D1040404
LAB Type Physician Office
Facility Name BAY AREA PEDIATRICS
Street 165 LOG CANOE CIRCLE STE E
City STEVENSVILLE
State MD
ZIP 21666
Phone 410 643-1000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2025
Certificate Expiration Date 5/8/2027
Facility Type Physician Office
Lab Director D JAMES KALLIONGIS MD

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