21D2017043 CLIA NUMBER - CLINICAL ASSOCIATES- AMBULATORY SURGERY CENTER ASC

Laboratory Demographics

  • CLIA Code: 21D2017043
  • Facility Name: CLINICAL ASSOCIATES- AMBULATORY SURGERY CENTER ASC
  • Facility Address: 515 FAIRMOUNT AVENUE SUITE 100
    TOWSON, MD
    ZIP 21286
  • Facility Phone: 410 494-1315
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JAMES M. CORKUM
  • NPI Number: 1982074001
  • Taxonomy: 261QA1903X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2017043
LAB Type Ambulatory Surgery Center
Facility Name CLINICAL ASSOCIATES- AMBULATORY SURGERY CENTER ASC
Street 515 FAIRMOUNT AVENUE SUITE 100
City TOWSON
State MD
ZIP 21286
Phone 410 494-1315
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2024
Certificate Expiration Date 12/1/2026
Facility Type Ambulatory Surgery Center
Lab Director JAMES M. CORKUM

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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