21D1049419 CLIA NUMBER - NINA KASHTELYAN MD

Laboratory Demographics

  • CLIA Code: 21D1049419
  • Facility Name: NINA KASHTELYAN MD
  • Facility Address: 4000 OLD COURT ROAD STE 205
    BALTIMORE, MD
    ZIP 21208
  • Facility Phone: 410 484-9950
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NINA KASHTELYAN
  • NPI Number: 1629038518
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D1049419
LAB Type Physician Office
Facility Name NINA KASHTELYAN MD
Street 4000 OLD COURT ROAD STE 205
City BALTIMORE
State MD
ZIP 21208
Phone 410 484-9950
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Physician Office
Lab Director NINA KASHTELYAN

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