21D2104057 CLIA NUMBER - CORAZON PANES-SANCHEZ(RISING SUN OFFICE

Laboratory Demographics

  • CLIA Code: 21D2104057
  • Facility Name: CORAZON PANES-SANCHEZ(RISING SUN OFFICE
  • Facility Address: 111 RYAN DRIVE
    RISING SUN, MD
    ZIP 21911
  • Facility Phone: 410 658-1300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CORAZON L. PANES-SANCHEZ
  • NPI Number: 1255156576
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 21D2104057
LAB Type Physician Office
Facility Name CORAZON PANES-SANCHEZ(RISING SUN OFFICE
Street 111 RYAN DRIVE
City RISING SUN
State MD
ZIP 21911
Phone 410 658-1300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Physician Office
Lab Director CORAZON L. PANES-SANCHEZ

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