21D2006154 CLIA NUMBER - BHAWNA BAHETHI, MD, LLC

Laboratory Demographics

  • CLIA Code: 21D2006154
  • Facility Name: BHAWNA BAHETHI, MD, LLC
  • Facility Address: 1600 CRAIN HWY S SUITE 501
    GLEN BURNIE, MD
    ZIP 21061
  • Facility Phone: 410 766-8911
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BHAWNA BAHETHI
  • NPI Number: 1629150586
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2006154
LAB Type Physician Office
Facility Name BHAWNA BAHETHI, MD, LLC
Street 1600 CRAIN HWY S SUITE 501
City GLEN BURNIE
State MD
ZIP 21061
Phone 410 766-8911
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2024
Certificate Expiration Date 4/13/2026
Facility Type Physician Office
Lab Director BHAWNA BAHETHI

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