21D2152922 CLIA NUMBER - HEALTH RELEAF LLC

Laboratory Demographics

  • CLIA Code: 21D2152922
  • Facility Name: HEALTH RELEAF LLC
  • Facility Address: 1406B CRAIN HWY SOUTH #304
    GLEN BURNIE, MD
    ZIP 21061
  • Facility Phone: 301 804-0844
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHANNON MARTIN CRNP
  • NPI Number: 1770255291
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2152922
LAB Type Physician Office
Facility Name HEALTH RELEAF LLC
Street 1406B CRAIN HWY SOUTH #304
City GLEN BURNIE
State MD
ZIP 21061
Phone 301 804-0844
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2024
Certificate Expiration Date 8/19/2026
Facility Type Physician Office
Lab Director SHANNON MARTIN CRNP

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