21D2034209 CLIA NUMBER - GLASS HEALTH PROGRAMAS INC MEDMARK TX CTRS ESSEX

Laboratory Demographics

  • CLIA Code: 21D2034209
  • Facility Name: GLASS HEALTH PROGRAMAS INC MEDMARK TX CTRS ESSEX
  • Facility Address: 8909 KELSO DRIVE
    ESSEX, MD
    ZIP 21221
  • Facility Phone: 410 486-2500
  • Facility Type: Other - NARCOTIC TREATMENT PROG
  • Facility Type: Waiver
  • Lab Director: YASHICA RUFFIN
  • NPI Number: 1598021917
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2034209
LAB Type Other - NARCOTIC TREATMENT PROG
Facility Name GLASS HEALTH PROGRAMAS INC MEDMARK TX CTRS ESSEX
Street 8909 KELSO DRIVE
City ESSEX
State MD
ZIP 21221
Phone 410 486-2500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Other - NARCOTIC TREATMENT PROG
Lab Director YASHICA RUFFIN

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