21D2204828 CLIA NUMBER - GAUDENZIA INC OWINGS MILLS

Laboratory Demographics

  • CLIA Code: 21D2204828
  • Facility Name: GAUDENZIA INC OWINGS MILLS
  • Facility Address: 10225 JENSEN LANE
    OWINGS MILLS, MD
    ZIP 21117
  • Facility Phone: 443 681-0776
  • Facility Type: Other - RESIDENTIAL TX
  • Facility Type: Waiver
  • Lab Director: KRISTY BLALOCK
  • NPI Number: 1265645493
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2204828
LAB Type Other - RESIDENTIAL TX
Facility Name GAUDENZIA INC OWINGS MILLS
Street 10225 JENSEN LANE
City OWINGS MILLS
State MD
ZIP 21117
Phone 443 681-0776
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2024
Certificate Expiration Date 12/9/2026
Facility Type Other - RESIDENTIAL TX
Lab Director KRISTY BLALOCK

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