21D2076126 CLIA NUMBER - ADVANCED RADIOLOGY FISHER MEDICAL BUILDING

Laboratory Demographics

  • CLIA Code: 21D2076126
  • Facility Name: ADVANCED RADIOLOGY FISHER MEDICAL BUILDING
  • Facility Address: 193 STONER AVENUE STE 200
    WESTMINSTER, MD
    ZIP 21157
  • Facility Phone: 443 487-5720
  • Facility Type: Other - OUTPATIENT RADIOLOGY OFFI
  • Facility Type: Waiver
  • Lab Director: FREDERIC K. YEGANEH
  • NPI Number: 1497053045
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 21D2076126
LAB Type Other - OUTPATIENT RADIOLOGY OFFI
Facility Name ADVANCED RADIOLOGY FISHER MEDICAL BUILDING
Street 193 STONER AVENUE STE 200
City WESTMINSTER
State MD
ZIP 21157
Phone 443 487-5720
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 FREDERIC K. YEGANEH

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This page was last updated on: 6/4/2025