21D1082254 CLIA NUMBER - ADVANCED RADIOLOGY WHITE SQUARE IMAGING

Laboratory Demographics

  • CLIA Code: 21D1082254
  • Facility Name: ADVANCED RADIOLOGY WHITE SQUARE IMAGING
  • Facility Address: 9105 FRANKLIN SQUARE DRIVE
    BALTIMORE, MD
    ZIP 21237
  • Facility Phone: 443 436-1245
  • Facility Type: Other - OUTPATIENT RADIOLOGY
  • Facility Type: Waiver
  • Lab Director: JAMES WINTHROP
  • NPI Number: 1285451518
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 21D1082254
LAB Type Other - OUTPATIENT RADIOLOGY
Facility Name ADVANCED RADIOLOGY WHITE SQUARE IMAGING
Street 9105 FRANKLIN SQUARE DRIVE
City BALTIMORE
State MD
ZIP 21237
Phone 443 436-1245
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 Other - OUTPATIENT RADIOLOGY
Lab Director JAMES WINTHROP

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