21D2132053 CLIA NUMBER - LAUREL LAKES DIALYSIS

Laboratory Demographics

  • CLIA Code: 21D2132053
  • Facility Name: LAUREL LAKES DIALYSIS
  • Facility Address: 14500 LAUREL PLACE
    LAUREL, MD
    ZIP 20707
  • Facility Phone: 301 497-5454
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: QUAN WANG
  • NPI Number: 1235667130
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2132053
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LAUREL LAKES DIALYSIS
Street 14500 LAUREL PLACE
City LAUREL
State MD
ZIP 20707
Phone 301 497-5454
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2025
Certificate Expiration Date 6/11/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director QUAN WANG

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