21D2079915 CLIA NUMBER - PENINSULA ORTHOPAEDIC ASSOCIATES

Laboratory Demographics

  • CLIA Code: 21D2079915
  • Facility Name: PENINSULA ORTHOPAEDIC ASSOCIATES
  • Facility Address: 1675 WOODBROOKE DRIVE
    SALISBURY, MD
    ZIP 21804
  • Facility Phone: 410 749-4194
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PASQUALE PETRERA
  • NPI Number: 1780814202
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 21D2079915
LAB Type Physician Office
Facility Name PENINSULA ORTHOPAEDIC ASSOCIATES
Street 1675 WOODBROOKE DRIVE
City SALISBURY
State MD
ZIP 21804
Phone 410 749-4194
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/26/2024
Certificate Expiration Date 6/25/2026
Facility Type Physician Office
Lab Director PASQUALE PETRERA

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