21D2058140 CLIA NUMBER - WHITE FLINT RECOVERY EASTERN SHORE INC

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Laboratory Demographics

CLIA Number: 21D2058140

Facility Name: WHITE FLINT RECOVERY EASTERN SHORE INC

Facility Address:
207 EAST MAIN STREET
SALISBURY, MD
ZIP 21801
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Facility Phone Number: 410 749-6422

Facility Type: Other - SUBSTANCE ABUSE FACILITY

Certificate Type: Waiver

NPI Number: 1790709442

Taxonomy: 261QM0850X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

CLIA Record

Field Name	Field Value
CLIA Number	21D2058140
LAB Type	Other - SUBSTANCE ABUSE FACILITY
Facility Name	WHITE FLINT RECOVERY EASTERN SHORE INC
Street	207 EAST MAIN STREET
City	SALISBURY
State	MD
ZIP	21801
Phone	410 749-6422
CertificateType	4
CertificateEffectiveDate	4/30/2023
CertificateExpirationDate	4/29/2025
FacilityType	Waiver

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