21D2131288 CLIA NUMBER - BW PRIMARY CARE FOUNDRY ROW

Laboratory Demographics

CLIA Number: 21D2131288

Facility Name: BW PRIMARY CARE FOUNDRY ROW

Facility Address:
10084 REISTERSTOWN ROAD STE 200A
OWINGS MILLS, MD
ZIP 21117
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Facility Phone Number: 410 552-5050

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1891247003

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	21D2131288
LAB Type	Physician Office
Facility Name	BW PRIMARY CARE FOUNDRY ROW
Street	10084 REISTERSTOWN ROAD STE 200A
City	OWINGS MILLS
State	MD
ZIP	21117
Phone	410 552-5050
CertificateType	4
CertificateEffectiveDate	5/25/2023
CertificateExpirationDate	5/24/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024