21D2002117 CLIA NUMBER - DEERFIELD HEALTHCARE CORP DBA ACTIVE DAY-PARKVILLE

Laboratory Demographics

  • CLIA Code: 21D2002117
  • Facility Name: DEERFIELD HEALTHCARE CORP DBA ACTIVE DAY-PARKVILLE
  • Facility Address: 3327 E JOPPA ROAD
    PARKVILLE, MD
    ZIP 21234
  • Facility Phone: 410 663-9501
  • Facility Type: Other - MEDICAL ADULT DAYCARE
  • Facility Type: Waiver
  • Lab Director: BRIAN C. WALLACE
  • NPI Number: 1083755326
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2002117
LAB Type Other - MEDICAL ADULT DAYCARE
Facility Name DEERFIELD HEALTHCARE CORP DBA ACTIVE DAY-PARKVILLE
Street 3327 E JOPPA ROAD
City PARKVILLE
State MD
ZIP 21234
Phone 410 663-9501
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/7/2024
Certificate Expiration Date 1/6/2026
Facility Type Other - MEDICAL ADULT DAYCARE
Lab Director BRIAN C. WALLACE

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