21D2119914 CLIA NUMBER - WEST ANNAPOLIS SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 21D2119914
  • Facility Name: WEST ANNAPOLIS SURGERY CENTER LLC
  • Facility Address: 104 RIDGELY AVE STE 301
    ANNAPOLIS, MD
    ZIP 21401
  • Facility Phone: 410 266-7120
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. HENRY D. SANDEL IV MD
  • NPI Number: 1467844068
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2119914
LAB Type Ambulatory Surgery Center
Facility Name WEST ANNAPOLIS SURGERY CENTER LLC
Street 104 RIDGELY AVE STE 301
City ANNAPOLIS
State MD
ZIP 21401
Phone 410 266-7120
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2024
Certificate Expiration Date 10/5/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. HENRY D. SANDEL IV MD

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