21D2197037 CLIA NUMBER - CLEARWAY SURGERY CENTER OF PRINCE FREDERICK

Laboratory Demographics

  • CLIA Code: 21D2197037
  • Facility Name: CLEARWAY SURGERY CENTER OF PRINCE FREDERICK
  • Facility Address: 110 HOSPITAL RD SUITE 304
    PRINCE FREDERICK, MD
    ZIP 20678
  • Facility Phone: 410 571-2946
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: EHSAN ABDESHAHIAN
  • NPI Number: 1427572270
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 21D2197037
LAB Type Ambulatory Surgery Center
Facility Name CLEARWAY SURGERY CENTER OF PRINCE FREDERICK
Street 110 HOSPITAL RD SUITE 304
City PRINCE FREDERICK
State MD
ZIP 20678
Phone 410 571-2946
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2024
Certificate Expiration Date 11/11/2026
Facility Type Ambulatory Surgery Center
Lab Director EHSAN ABDESHAHIAN

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This page was last updated on: 6/4/2025