21D2005790 CLIA NUMBER - PENINSULA IMAGING, LLC

Laboratory Demographics

  • CLIA Code: 21D2005790
  • Facility Name: PENINSULA IMAGING, LLC
  • Facility Address: 1655 WOODBROOKE DRIVE SUITE 101
    SALISBURY, MD
    ZIP 21804
  • Facility Phone: 410 543-1143
  • Facility Type: Other - IMAGING/RADIOLOGY CTR
  • Facility Type: Waiver
  • Lab Director: PETER LIBBY
  • NPI Number: 1255733705
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 21D2005790
LAB Type Other - IMAGING/RADIOLOGY CTR
Facility Name PENINSULA IMAGING, LLC
Street 1655 WOODBROOKE DRIVE SUITE 101
City SALISBURY
State MD
ZIP 21804
Phone 410 543-1143
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2024
Certificate Expiration Date 4/5/2026
Facility Type Other - IMAGING/RADIOLOGY CTR
Lab Director PETER LIBBY

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