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21D2077525 CLIA NUMBER - WICOMICO CO PUBLIC SCHOOLS-WICOMICO HS

Laboratory Demographics

CLIA Number: 21D2077525

Facility Name: WICOMICO CO PUBLIC SCHOOLS-WICOMICO HS

Facility Address:
2424 NORTHGATE DR
SALISBURY, MD
ZIP 21802
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Facility Phone Number: 410 677-4412

Facility Type: School/Student Health Service

Certificate Type: Waiver
NPI Number: 1629013925

Taxonomy: 313M00000X - Nursing Facility/Intermediate Care Facility
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.

CLIA Record

Field Name Field Value
CLIA Number 21D2077525
LAB Type School/Student Health Service
Facility Name WICOMICO CO PUBLIC SCHOOLS-WICOMICO HS
Street 2424 NORTHGATE DR
City SALISBURY
State MD
ZIP 21802
Phone 410 677-4412
CertificateType 4
CertificateEffectiveDate 5/9/2024
CertificateExpirationDate 5/8/2026
FacilityType Waiver

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