21D1063873 CLIA NUMBER - ATS OF CECIL CO LLC DBA PINE HEIGHTS TREATMENT CTR

Laboratory Demographics

  • CLIA Code: 21D1063873
  • Facility Name: ATS OF CECIL CO LLC DBA PINE HEIGHTS TREATMENT CTR
  • Facility Address: 3455 WILKENS AVE LOWER LEVEL 20
    BALTIMORE, MD
    ZIP 21229
  • Facility Phone: (410) 646-6960
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: DR. ENRIQUE OLIVARES
  • NPI Number: 1033507827
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D1063873
LAB Type Comp. Outpatient Rehab Facility
Facility Name ATS OF CECIL CO LLC DBA PINE HEIGHTS TREATMENT CTR
Street 3455 WILKENS AVE LOWER LEVEL 20
City BALTIMORE
State MD
ZIP 21229
Phone 4106466960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/24/2025
Certificate Expiration Date 1/23/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director DR. ENRIQUE OLIVARES

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This page was last updated on: 6/29/2026