21D2076135 CLIA NUMBER - ADVANCED RADIOLOGY TIMONIUM CROSSING

Laboratory Demographics

  • CLIA Code: 21D2076135
  • Facility Name: ADVANCED RADIOLOGY TIMONIUM CROSSING
  • Facility Address: 2080 YORK ROAD STE 160
    TIMONIUM, MD
    ZIP 21093
  • Facility Phone: 443 436-1245
  • Facility Type: Other - OUTPATIENT RADIOLOGY OFFI
  • Facility Type: Waiver
  • Lab Director: FREDERICK K. YEGANEH
  • NPI Number: 1326305053
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2076135
LAB Type Other - OUTPATIENT RADIOLOGY OFFI
Facility Name ADVANCED RADIOLOGY TIMONIUM CROSSING
Street 2080 YORK ROAD STE 160
City TIMONIUM
State MD
ZIP 21093
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 FREDERICK K. YEGANEH

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