21D2213882 CLIA NUMBER - ANNAPOLIS ENDOSCOPY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 21D2213882
  • Facility Name: ANNAPOLIS ENDOSCOPY CENTER, LLC
  • Facility Address: 1419 FOREST DR SUITE 105
    ANNAPOLIS, MD
    ZIP 21403
  • Facility Phone: 410 215-3154
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: RUDY RAI
  • NPI Number: 1023546116
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D2213882
LAB Type Ambulatory Surgery Center
Facility Name ANNAPOLIS ENDOSCOPY CENTER, LLC
Street 1419 FOREST DR SUITE 105
City ANNAPOLIS
State MD
ZIP 21403
Phone 410 215-3154
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Ambulatory Surgery Center
Lab Director RUDY RAI

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