21D2152164 CLIA NUMBER - LOCH RAVEN DIALYSIS

Laboratory Demographics

  • CLIA Code: 21D2152164
  • Facility Name: LOCH RAVEN DIALYSIS
  • Facility Address: 5315 YORK ROAD
    BALTIMORE, MD
    ZIP 21212
  • Facility Phone: 410 323-8790
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: VEENA K. ACHARYA MD
  • NPI Number: 1639660962
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2152164
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LOCH RAVEN DIALYSIS
Street 5315 YORK ROAD
City BALTIMORE
State MD
ZIP 21212
Phone 410 323-8790
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2024
Certificate Expiration Date 8/5/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director VEENA K. ACHARYA MD

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