21D1067055 CLIA NUMBER - GREEN SPRING INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 21D1067055
  • Facility Name: GREEN SPRING INTERNAL MEDICINE
  • Facility Address: 2360 W JOPPA RD SUITE 210
    LUTHERVILLE, MD
    ZIP 21093
  • Facility Phone: 410 583-2890
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HOLLY R. DAHLMAN
  • NPI Number: 1558310490
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D1067055
LAB Type Physician Office
Facility Name GREEN SPRING INTERNAL MEDICINE
Street 2360 W JOPPA RD SUITE 210
City LUTHERVILLE
State MD
ZIP 21093
Phone 410 583-2890
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2025
Certificate Expiration Date 4/9/2027
Facility Type Physician Office
Lab Director HOLLY R. DAHLMAN

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