21D2176574 CLIA NUMBER - WVS FREDERICK ASC, LLC

Laboratory Demographics

CLIA Number: 21D2176574

Facility Name: WVS FREDERICK ASC, LLC

Facility Address:
75 THOMAS JOHNSON DR, SUITE 1
FREDERICK, MD
ZIP 21702
Get Directions

Facility Phone Number: 301 378-0608

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1386391332

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	21D2176574
LAB Type	Ambulatory Surgery Center
Facility Name	WVS FREDERICK ASC, LLC
Street	75 THOMAS JOHNSON DR, SUITE 1
City	FREDERICK
State	MD
ZIP	21702
Phone	301 378-0608
CertificateType	4
CertificateEffectiveDate	12/18/2023
CertificateExpirationDate	12/17/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

This page was last updated on: 4/23/2024