21D2059867 CLIA NUMBER - ANNAPOLIS DIALYSIS

Laboratory Demographics

  • CLIA Code: 21D2059867
  • Facility Name: ANNAPOLIS DIALYSIS
  • Facility Address: 1127 WEST STREET
    ANNAPOLIS, MD
    ZIP 21401
  • Facility Phone: 410 263-1346
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JONATHAN B. RUDICK
  • NPI Number: 1740529932
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2059867
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name ANNAPOLIS DIALYSIS
Street 1127 WEST STREET
City ANNAPOLIS
State MD
ZIP 21401
Phone 410 263-1346
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/3/2025
Certificate Expiration Date 6/2/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JONATHAN B. RUDICK

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