21D2154413 CLIA NUMBER - LIVINGSTON VILLAGE DIALYSIS

Laboratory Demographics

  • CLIA Code: 21D2154413
  • Facility Name: LIVINGSTON VILLAGE DIALYSIS
  • Facility Address: 11700 LIVINGSTON ROAD
    FORT WASHINGTON, MD
    ZIP 20744
  • Facility Phone: 301 292-1804
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ERIC ANTWI-DONKER MD
  • NPI Number: 1306323050
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2154413
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name LIVINGSTON VILLAGE DIALYSIS
Street 11700 LIVINGSTON ROAD
City FORT WASHINGTON
State MD
ZIP 20744
Phone 301 292-1804
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2024
Certificate Expiration Date 9/11/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ERIC ANTWI-DONKER MD

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