21D1050588 CLIA NUMBER - INSTITUTES FOR BEHAVIOR RESOURCES INC

Laboratory Demographics

CLIA Number: 21D1050588

Facility Name: INSTITUTES FOR BEHAVIOR RESOURCES INC

Facility Address:
2104 MARYLAND AVENUE
BALTIMORE, MD
ZIP 21218
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Facility Phone Number: 410 752-6080

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1437564044

Taxonomy: 101YM0800X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	21D1050588
LAB Type	Other
Facility Name	INSTITUTES FOR BEHAVIOR RESOURCES INC
Street	2104 MARYLAND AVENUE
City	BALTIMORE
State	MD
ZIP	21218
Phone	410 752-6080
CertificateType	4
CertificateEffectiveDate	4/11/2023
CertificateExpirationDate	4/10/2025
FacilityType	Waiver

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