21D2146177 CLIA NUMBER - EVOLVE LIFE CENTERS IOP, LLC

Laboratory Demographics

  • CLIA Code: 21D2146177
  • Facility Name: EVOLVE LIFE CENTERS IOP, LLC
  • Facility Address: 2528 MOUNTAIN ROAD SUITE 204
    PASADENA, MD
    ZIP 21122
  • Facility Phone: 443 548-3733
  • Facility Type: Other - IOP SUBSTANCE ABUSE
  • Facility Type: Waiver
  • Lab Director: OLUWATOYIN ADEKEYE
  • NPI Number: 1568123966
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2146177
LAB Type Other - IOP SUBSTANCE ABUSE
Facility Name EVOLVE LIFE CENTERS IOP, LLC
Street 2528 MOUNTAIN ROAD SUITE 204
City PASADENA
State MD
ZIP 21122
Phone 443 548-3733
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2024
Certificate Expiration Date 3/22/2026
Facility Type Other - IOP SUBSTANCE ABUSE
Lab Director OLUWATOYIN ADEKEYE

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