21D2115777 CLIA NUMBER - GLASS HEALTH PROGRAMS, INC DBA MTC MT VERNON

Laboratory Demographics

  • CLIA Code: 21D2115777
  • Facility Name: GLASS HEALTH PROGRAMS, INC DBA MTC MT VERNON
  • Facility Address: 817 N CALVERT STREET
    BALTIMORE, MD
    ZIP 21202
  • Facility Phone: 443 290-6424
  • Facility Type: Other - NARCOTIC TREATMENT PROGRA
  • Facility Type: Waiver
  • Lab Director: YASHICA RUFFIN
  • NPI Number: 1154789014
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2115777
LAB Type Other - NARCOTIC TREATMENT PROGRA
Facility Name GLASS HEALTH PROGRAMS, INC DBA MTC MT VERNON
Street 817 N CALVERT STREET
City BALTIMORE
State MD
ZIP 21202
Phone 443 290-6424
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2024
Certificate Expiration Date 7/12/2026
Facility Type Other - NARCOTIC TREATMENT PROGRA
Lab Director YASHICA RUFFIN

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