21D2204130 CLIA NUMBER - ROLAND PARK COUNTRY SCHOOL

Laboratory Demographics

  • CLIA Code: 21D2204130
  • Facility Name: ROLAND PARK COUNTRY SCHOOL
  • Facility Address: 5204 ROLAND AVE
    BALTIMORE, MD
    ZIP 21210
  • Facility Phone: 410 323-5591
  • Facility Type: School/Student Health Service
  • Facility Type: Waiver
  • Lab Director: ADRIANNA BRAVO
  • NPI Number: 1760672729
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 21D2204130
LAB Type School/Student Health Service
Facility Name ROLAND PARK COUNTRY SCHOOL
Street 5204 ROLAND AVE
City BALTIMORE
State MD
ZIP 21210
Phone 410 323-5591
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/8/2024
Certificate Expiration Date 12/7/2026
Facility Type School/Student Health Service
Lab Director ADRIANNA BRAVO

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