21D2202097 CLIA NUMBER - BALTIMORE SAFE HAVEN

Laboratory Demographics

  • CLIA Code: 21D2202097
  • Facility Name: BALTIMORE SAFE HAVEN
  • Facility Address: 2117 N CHARLES
    BALTIMORE, MD
    ZIP 21218
  • Facility Phone: 443 286-7767
  • Facility Type: Other - NON PROFIT ORGANIZATION
  • Facility Type: Waiver
  • Lab Director: BILLIE J. TYLER
  • NPI Number: 1447231576
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2202097
LAB Type Other - NON PROFIT ORGANIZATION
Facility Name BALTIMORE SAFE HAVEN
Street 2117 N CHARLES
City BALTIMORE
State MD
ZIP 21218
Phone 443 286-7767
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/1/2024
Certificate Expiration Date 9/30/2026
Facility Type Other - NON PROFIT ORGANIZATION
Lab Director BILLIE J. TYLER

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