21D1078564 CLIA NUMBER - MASSACHUSETTS AVENUE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 21D1078564
  • Facility Name: MASSACHUSETTS AVENUE SURGERY CENTER
  • Facility Address: 6400 GOLDSBORO ROAD SUITE 400
    BETHESDA, MD
    ZIP 20817
  • Facility Phone: 301 263-0800
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PETER B. SHIMM
  • NPI Number: 1528045820
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 21D1078564
LAB Type Ambulatory Surgery Center
Facility Name MASSACHUSETTS AVENUE SURGERY CENTER
Street 6400 GOLDSBORO ROAD SUITE 400
City BETHESDA
State MD
ZIP 20817
Phone 301 263-0800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type Ambulatory Surgery Center
Lab Director PETER B. SHIMM

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