21D1078344 CLIA NUMBER - GOODTIME PEDIATRICS

Laboratory Demographics

CLIA Number: 21D1078344

Facility Name: GOODTIME PEDIATRICS

Facility Address:
5805 MORAVIA ROAD
BALTIMORE, MD
ZIP 21206
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Facility Phone Number: 410 325-5700

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1093926206

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	21D1078344
LAB Type	Physician Office
Facility Name	GOODTIME PEDIATRICS
Street	5805 MORAVIA ROAD
City	BALTIMORE
State	MD
ZIP	21206
Phone	410 325-5700
CertificateType	4
CertificateEffectiveDate	4/24/2023
CertificateExpirationDate	4/23/2025
FacilityType	Waiver

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