21D2141151 CLIA NUMBER - LIFEWAY ADULT MEDICAL DAY CENTER LLC

Laboratory Demographics

CLIA Number: 21D2141151

Facility Name: LIFEWAY ADULT MEDICAL DAY CENTER LLC

Facility Address:
30 NEW PLANT COURT
OWINGS MILLS, MD
ZIP 21117
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Facility Phone Number: 443 929-1478

Facility Type: Other - ADULT MEDICAL DAY CENTER

Certificate Type: Waiver

NPI Number: 1407361660

Taxonomy: 261QA0600X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D2141151
LAB Type	Other - ADULT MEDICAL DAY CENTER
Facility Name	LIFEWAY ADULT MEDICAL DAY CENTER LLC
Street	30 NEW PLANT COURT
City	OWINGS MILLS
State	MD
ZIP	21117
Phone	443 929-1478
CertificateType	4
CertificateEffectiveDate	12/8/2023
CertificateExpirationDate	12/7/2025
FacilityType	Waiver

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