21D2173270 CLIA NUMBER - MONTE NIDO MARYLAND LLC

Laboratory Demographics

CLIA Code: 21D2173270
Facility Name: MONTE NIDO MARYLAND LLC
Facility Address: 3100 ROXBURY MILLS ROAD
GLENWOOD, MD
ZIP 21738
Facility Phone: 410 849-6116
Facility Type: Other - LIMITED PRIVATE INPATIENT
Facility Type: Waiver
Lab Director: DR. KATHLEEN M. MCSHANE
NPI Number: 1649744327
Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness

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CLIA Record

Field Name	Field Value
CLIA Number	21D2173270
LAB Type	Other - LIMITED PRIVATE INPATIENT
Facility Name	MONTE NIDO MARYLAND LLC
Street	3100 ROXBURY MILLS ROAD
City	GLENWOOD
State	MD
ZIP	21738
Phone	410 849-6116
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	10/9/2023
Certificate Expiration Date	10/8/2025
Facility Type	Other - LIMITED PRIVATE INPATIENT
Lab Director	DR. KATHLEEN M. MCSHANE

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