21D1077198 CLIA NUMBER - DIALYSIS ACCESS SPECIALIST TIMONIUM

Laboratory Demographics

  • CLIA Code: 21D1077198
  • Facility Name: DIALYSIS ACCESS SPECIALIST TIMONIUM
  • Facility Address: 2405 YORK ROAD STE 100
    TIMONIUM, MD
    ZIP 21093
  • Facility Phone: 410 560-2257
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT FULD
  • NPI Number: 1396142733
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D1077198
LAB Type Physician Office
Facility Name DIALYSIS ACCESS SPECIALIST TIMONIUM
Street 2405 YORK ROAD STE 100
City TIMONIUM
State MD
ZIP 21093
Phone 410 560-2257
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2023
Certificate Expiration Date 12/3/2025
Facility Type Physician Office
Lab Director ROBERT FULD

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