21D2075400 CLIA NUMBER - CHECKERSPOT SURGERY CENTERS LLC

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Laboratory Demographics

CLIA Number: 21D2075400

Facility Name: CHECKERSPOT SURGERY CENTERS LLC

Facility Address:
1130 ANNAPOLIS ROAD SUITE 102
ODENTON, MD
ZIP 21113
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Facility Phone Number: 410 672-2255

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1447685458

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D2075400
LAB Type	Ambulatory Surgery Center
Facility Name	CHECKERSPOT SURGERY CENTERS LLC
Street	1130 ANNAPOLIS ROAD SUITE 102
City	ODENTON
State	MD
ZIP	21113
Phone	410 672-2255
CertificateType	4
CertificateEffectiveDate	3/27/2024
CertificateExpirationDate	3/26/2026
FacilityType	Waiver

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