21D1057310 CLIA NUMBER - GREENSPRING SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 21D1057310
  • Facility Name: GREENSPRING SURGERY CENTER LLC
  • Facility Address: 2700 QUARRY LAKE DRIVE STE 100
    BALTIMORE, MD
    ZIP 21209
  • Facility Phone: 410 653-0077
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. JASON P. BROKAW MD
  • NPI Number: 1033141825
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D1057310
LAB Type Ambulatory Surgery Center
Facility Name GREENSPRING SURGERY CENTER LLC
Street 2700 QUARRY LAKE DRIVE STE 100
City BALTIMORE
State MD
ZIP 21209
Phone 410 653-0077
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/8/2024
Certificate Expiration Date 8/7/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. JASON P. BROKAW MD

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