21D2216033 CLIA NUMBER - PEDIATRIC ENDOCRINOLOGY OF ANNAPOLIS

Laboratory Demographics

CLIA Number: 21D2216033

Facility Name: PEDIATRIC ENDOCRINOLOGY OF ANNAPOLIS

Facility Address:
560 RIVERSIDE DRIVE #B102
SALISBURY, MD
ZIP 21801
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Facility Phone Number: 443 203-8202

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1912532490

Taxonomy: 2080P0205X - Pediatrics
A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands.

CLIA Record

Field Name	Field Value
CLIA Number	21D2216033
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	PEDIATRIC ENDOCRINOLOGY OF ANNAPOLIS
Street	560 RIVERSIDE DRIVE #B102
City	SALISBURY
State	MD
ZIP	21801
Phone	443 203-8202
CertificateType	4
CertificateEffectiveDate	3/9/2023
CertificateExpirationDate	3/8/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024