21D2165420 CLIA NUMBER - OC WELLNESS, LLC

Laboratory Demographics

  • CLIA Code: 21D2165420
  • Facility Name: OC WELLNESS, LLC
  • Facility Address: 1410 S SALISBURY BLVD UNIT 1
    SALISBURY, MD
    ZIP 21801
  • Facility Phone: 443 735-4038
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEESHA HOLDEN-WHITE
  • NPI Number: 1558923672
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2165420
LAB Type Physician Office
Facility Name OC WELLNESS, LLC
Street 1410 S SALISBURY BLVD UNIT 1
City SALISBURY
State MD
ZIP 21801
Phone 443 735-4038
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Physician Office
Lab Director KEESHA HOLDEN-WHITE

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