21D2047627 CLIA NUMBER - SOUTH RIVER PEDIATRICS- DUNKIRK

Laboratory Demographics

  • CLIA Code: 21D2047627
  • Facility Name: SOUTH RIVER PEDIATRICS- DUNKIRK
  • Facility Address: 10845 TOWNE CENTER BLVD
    DUNKIRK, MD
    ZIP 20754
  • Facility Phone: 410 956-6303
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AZAM BAIG
  • NPI Number: 1124123716
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2047627
LAB Type Physician Office
Facility Name SOUTH RIVER PEDIATRICS- DUNKIRK
Street 10845 TOWNE CENTER BLVD
City DUNKIRK
State MD
ZIP 20754
Phone 410 956-6303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/28/2024
Certificate Expiration Date 9/27/2026
Facility Type Physician Office
Lab Director AZAM BAIG

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