21D1084857 CLIA NUMBER - HANOVER PARKWAY SURGERY CENTER

Laboratory Demographics

CLIA Number: 21D1084857

Facility Name: HANOVER PARKWAY SURGERY CENTER

Facility Address:
7300 HANOVER DRIVE #204
GREENBELT, MD
ZIP 20770
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Facility Phone Number: 301 704-0681

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1275710436

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D1084857
LAB Type	Ambulatory Surgery Center
Facility Name	HANOVER PARKWAY SURGERY CENTER
Street	7300 HANOVER DRIVE #204
City	GREENBELT
State	MD
ZIP	20770
Phone	301 704-0681
CertificateType	4
CertificateEffectiveDate	6/5/2022
CertificateExpirationDate	6/4/2024
FacilityType	Waiver

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