21D2141863 CLIA NUMBER - DAVID'S LOFT CLINICAL PROGRAMS

Laboratory Demographics

CLIA Number: 21D2141863

Facility Name: DAVID'S LOFT CLINICAL PROGRAMS

Facility Address:
2641 MARYLAND AVENUE
BALTIMORE, MD
ZIP 21218
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Facility Phone Number: 410 800-4226

Facility Type: Other - SUBSTANCE ABUSE

Certificate Type: Accreditation

NPI Number: 1285175273

Taxonomy: 101YA0400X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	21D2141863
LAB Type	Other - SUBSTANCE ABUSE
Facility Name	DAVID'S LOFT CLINICAL PROGRAMS
Street	2641 MARYLAND AVENUE
City	BALTIMORE
State	MD
ZIP	21218
Phone	410 800-4226
CertificateType	1
CertificateEffectiveDate	7/3/2023
CertificateExpirationDate	7/2/2025
FacilityType	Accreditation

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