21D2135313 CLIA NUMBER - LAKEVIEW SURGERY CENTER LLC

Laboratory Demographics

  • CLIA Code: 21D2135313
  • Facility Name: LAKEVIEW SURGERY CENTER LLC
  • Facility Address: 17001 SCIENCE DRIVE SUITE 114
    BOWIE, MD
    ZIP 20715
  • Facility Phone: 301 985-2830
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: ALYSON L. HALL MD
  • NPI Number: 1629429410
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2135313
LAB Type Ambulatory Surgery Center
Facility Name LAKEVIEW SURGERY CENTER LLC
Street 17001 SCIENCE DRIVE SUITE 114
City BOWIE
State MD
ZIP 20715
Phone 301 985-2830
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2025
Certificate Expiration Date 8/20/2027
Facility Type Ambulatory Surgery Center
Lab Director ALYSON L. HALL MD

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