21D2175383 CLIA NUMBER - APPLIED IMMUNOGENETICS LABORATORY

Laboratory Demographics

  • CLIA Code: 21D2175383
  • Facility Name: APPLIED IMMUNOGENETICS LABORATORY
  • Facility Address: 11419 CRONRIDGE DRIVE SUITE 17
    OWINGS MILLS, MD
    ZIP 21117
  • Facility Phone: 443 668-7242
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: REUT HOD DVORAI
  • NPI Number: 1689206112
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 21D2175383
LAB Type Independent
Facility Name APPLIED IMMUNOGENETICS LABORATORY
Street 11419 CRONRIDGE DRIVE SUITE 17
City OWINGS MILLS
State MD
ZIP 21117
Phone 443 668-7242
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 3/2/2024
Certificate Expiration Date 3/1/2026
Facility Type Independent
Lab Director REUT HOD DVORAI

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