21D2039161 CLIA NUMBER - PREMISE HEALTH OF MARYLAND MEDICAL, PC

Laboratory Demographics

  • CLIA Code: 21D2039161
  • Facility Name: PREMISE HEALTH OF MARYLAND MEDICAL, PC
  • Facility Address: 250 SCHILLING CIRCLE
    HUNT VALLEY, MD
    ZIP 21030
  • Facility Phone: 410 773-6550
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. COLUMBUS GILES
  • NPI Number: 1912424581
  • Taxonomy: 314000000X - Skilled Nursing Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2039161
LAB Type Physician Office
Facility Name PREMISE HEALTH OF MARYLAND MEDICAL, PC
Street 250 SCHILLING CIRCLE
City HUNT VALLEY
State MD
ZIP 21030
Phone 410 773-6550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2024
Certificate Expiration Date 4/2/2026
Facility Type Physician Office
Lab Director DR. COLUMBUS GILES

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