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21D2082623 CLIA NUMBER - ADULLUM COMMUNITY HEALTHCARE CTR

Laboratory Demographics

CLIA Number: 21D2082623

Facility Name: ADULLUM COMMUNITY HEALTHCARE CTR

Facility Address:
644 E 33RD STREET
BALTIMORE, MD
ZIP 21218
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Facility Phone Number: 410 871-8537

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1376758391

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 21D2082623
LAB Type Physician Office
Facility Name ADULLUM COMMUNITY HEALTHCARE CTR
Street 644 E 33RD STREET
City BALTIMORE
State MD
ZIP 21218
Phone 410 871-8537
CertificateType 4
CertificateEffectiveDate 8/19/2022
CertificateExpirationDate 8/18/2024
FacilityType Waiver

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