21D2076122 CLIA NUMBER - ADVANCED RADIOLOGY - HARFORD

Laboratory Demographics

  • CLIA Code: 21D2076122
  • Facility Name: ADVANCED RADIOLOGY - HARFORD
  • Facility Address: 9101 FRANKLIN SQUARE DRIVE #101
    BALTIMORE, MD
    ZIP 21237
  • Facility Phone: 443 436-1245
  • Facility Type: Other - OUTPATIENT RADIOLOGY OFFI
  • Facility Type: Waiver
  • Lab Director: DR. FREDERICK K. YEGANEH
  • NPI Number: 1467757575
  • Taxonomy: 261QP2000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2076122
LAB Type Other - OUTPATIENT RADIOLOGY OFFI
Facility Name ADVANCED RADIOLOGY - HARFORD
Street 9101 FRANKLIN SQUARE DRIVE #101
City BALTIMORE
State MD
ZIP 21237
Phone 443 436-1245
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2024
Certificate Expiration Date 4/10/2026
Facility Type Other - OUTPATIENT RADIOLOGY OFFI
Lab Director DR. FREDERICK K. YEGANEH

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