21D2170401 CLIA NUMBER - WOMEN OB/GYN

Laboratory Demographics

  • CLIA Code: 21D2170401
  • Facility Name: WOMEN OB/GYN
  • Facility Address: 1630 MAIN STREET STE 213
    CHESTER, MD
    ZIP 21619
  • Facility Phone: 410 224-2228
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACKIE NICHOLS
  • NPI Number: 1285655886
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 21D2170401
LAB Type Physician Office
Facility Name WOMEN OB/GYN
Street 1630 MAIN STREET STE 213
City CHESTER
State MD
ZIP 21619
Phone 410 224-2228
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type Physician Office
Lab Director JACKIE NICHOLS

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