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21D1043446 CLIA NUMBER - CHESAPEAKE UROLOGY ASSOCIATES LLC

Laboratory Demographics

CLIA Number: 21D1043446

Facility Name: CHESAPEAKE UROLOGY ASSOCIATES LLC

Facility Address:
410 MALCOLM DR SUITE A
WESTMINSTER, MD
ZIP 21157
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Facility Phone Number: 443 738-2889

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1306042064

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name Field Value
CLIA Number 21D1043446
LAB Type Physician Office
Facility Name CHESAPEAKE UROLOGY ASSOCIATES LLC
Street 410 MALCOLM DR SUITE A
City WESTMINSTER
State MD
ZIP 21157
Phone 443 738-2889
CertificateType 4
CertificateEffectiveDate 6/1/2023
CertificateExpirationDate 5/31/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024