21D1053333 CLIA NUMBER - CHESAPEAKE DIALYSIS CLINIC LLC

Laboratory Demographics

CLIA Number: 21D1053333

Facility Name: CHESAPEAKE DIALYSIS CLINIC LLC

Facility Address:
305 COLLEGE PARKWAY
ARNOLD, MD
ZIP 21012
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Facility Phone Number: 443 608-9876

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1598354706

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D1053333
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	CHESAPEAKE DIALYSIS CLINIC LLC
Street	305 COLLEGE PARKWAY
City	ARNOLD
State	MD
ZIP	21012
Phone	443 608-9876
CertificateType	4
CertificateEffectiveDate	4/20/2024
CertificateExpirationDate	4/19/2026
FacilityType	Waiver

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