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21D2029869 CLIA NUMBER - MANCHESTER MEDICAL CENTER LLC

Laboratory Demographics

CLIA Number: 21D2029869

Facility Name: MANCHESTER MEDICAL CENTER LLC

Facility Address:
3000 MANCHESTER ROAD STE 5
MANCHESTER, MD
ZIP 21102
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Facility Phone Number: 410 374-9500

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1821387358

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 21D2029869
LAB Type Physician Office
Facility Name MANCHESTER MEDICAL CENTER LLC
Street 3000 MANCHESTER ROAD STE 5
City MANCHESTER
State MD
ZIP 21102
Phone 410 374-9500
CertificateType 4
CertificateEffectiveDate 9/15/2023
CertificateExpirationDate 9/14/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024