21D2076252 CLIA NUMBER - HAVEN HOUSE, INC

Laboratory Demographics

  • CLIA Code: 21D2076252
  • Facility Name: HAVEN HOUSE, INC
  • Facility Address: 1195 AUGUSTINE HERMAN HWY
    ELKTON, MD
    ZIP 21921
  • Facility Phone: 410 398-9900
  • Facility Type: Other - HALFWAY HOUSE
  • Facility Type: Waiver
  • Lab Director: JOHN S. FOREAKER
  • NPI Number: 1265416994
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2076252
LAB Type Other - HALFWAY HOUSE
Facility Name HAVEN HOUSE, INC
Street 1195 AUGUSTINE HERMAN HWY
City ELKTON
State MD
ZIP 21921
Phone 410 398-9900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2024
Certificate Expiration Date 4/14/2026
Facility Type Other - HALFWAY HOUSE
Lab Director JOHN S. FOREAKER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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