21D2107472 CLIA NUMBER - JEV SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 21D2107472
  • Facility Name: JEV SURGERY CENTER
  • Facility Address: 4 PARK CENTER COURT STE 100
    OWINGS MILLS, MD
    ZIP 21117
  • Facility Phone: 410 484-8860
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. CARRIE A. HOUSSOCK
  • NPI Number: 1154951945
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2107472
LAB Type Ambulatory Surgery Center
Facility Name JEV SURGERY CENTER
Street 4 PARK CENTER COURT STE 100
City OWINGS MILLS
State MD
ZIP 21117
Phone 410 484-8860
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/14/2024
Certificate Expiration Date 1/13/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. CARRIE A. HOUSSOCK

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