21D2143931 CLIA NUMBER - BROOKSIDE HEALTH & WELLNESS LLC

Laboratory Demographics

  • CLIA Code: 21D2143931
  • Facility Name: BROOKSIDE HEALTH & WELLNESS LLC
  • Facility Address: 14689 GARRETT HWY
    OAKLAND, MD
    ZIP 21550
  • Facility Phone: 301 334-5610
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: RACHEL R. FRIEND-LANTZ
  • NPI Number: 1164930533
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2143931
LAB Type Practitioner Other
Facility Name BROOKSIDE HEALTH & WELLNESS LLC
Street 14689 GARRETT HWY
City OAKLAND
State MD
ZIP 21550
Phone 301 334-5610
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Practitioner Other
Lab Director RACHEL R. FRIEND-LANTZ

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