21D2144297 CLIA NUMBER - EDGEWOOD DIALYSIS

Laboratory Demographics

  • CLIA Code: 21D2144297
  • Facility Name: EDGEWOOD DIALYSIS
  • Facility Address: 1415 S MOUNTAIN ROAD SUITE 105
    JOPPA, MD
    ZIP 21085
  • Facility Phone: 410 671-6059
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ADAM R. BERLINER MD
  • NPI Number: 1578083648
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2144297
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name EDGEWOOD DIALYSIS
Street 1415 S MOUNTAIN ROAD SUITE 105
City JOPPA
State MD
ZIP 21085
Phone 410 671-6059
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ADAM R. BERLINER MD

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