21D1090055 CLIA NUMBER - CLARKVIEW SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 21D1090055
  • Facility Name: CLARKVIEW SURGERY CENTER
  • Facility Address: 1427 CLARKVIEW RD SUITE 300C
    BALTIMORE, MD
    ZIP 21209
  • Facility Phone: 410 296-0414
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MICHAEL D. COHEN
  • NPI Number: 1104372853
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 21D1090055
LAB Type Ambulatory Surgery Center
Facility Name CLARKVIEW SURGERY CENTER
Street 1427 CLARKVIEW RD SUITE 300C
City BALTIMORE
State MD
ZIP 21209
Phone 410 296-0414
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2025
Certificate Expiration Date 1/4/2027
Facility Type Ambulatory Surgery Center
Lab Director MICHAEL D. COHEN

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