21D1088589 CLIA NUMBER - BALTIMORE EYE SURGICAL CENTER

Laboratory Demographics

  • CLIA Code: 21D1088589
  • Facility Name: BALTIMORE EYE SURGICAL CENTER
  • Facility Address: 6231 N CHARLES STREET
    BALTIMORE, MD
    ZIP 21212
  • Facility Phone: 410 377-5821
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARCOS DOXANAS
  • NPI Number: 1720139512
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D1088589
LAB Type Ambulatory Surgery Center
Facility Name BALTIMORE EYE SURGICAL CENTER
Street 6231 N CHARLES STREET
City BALTIMORE
State MD
ZIP 21212
Phone 410 377-5821
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2024
Certificate Expiration Date 8/27/2026
Facility Type Ambulatory Surgery Center
Lab Director MARCOS DOXANAS

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