21D2107562 CLIA NUMBER - THE CHARLESTON SENIOR COMMUNITY

Laboratory Demographics

  • CLIA Code: 21D2107562
  • Facility Name: THE CHARLESTON SENIOR COMMUNITY
  • Facility Address: 45 SAINT PATRICK'S DRIVE
    WALDORF, MD
    ZIP 20603
  • Facility Phone: 301 932-7013
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: PHILIP WISOTSKY
  • NPI Number: 1336673177
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 21D2107562
LAB Type Assisted Living Facility
Facility Name THE CHARLESTON SENIOR COMMUNITY
Street 45 SAINT PATRICK'S DRIVE
City WALDORF
State MD
ZIP 20603
Phone 301 932-7013
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2024
Certificate Expiration Date 1/14/2026
Facility Type Assisted Living Facility
Lab Director PHILIP WISOTSKY

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