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21D2242089 CLIA NUMBER - ALLERGY AND ASTHMA CENTER OF CENTRAL MD

Laboratory Demographics

CLIA Number: 21D2242089

Facility Name: ALLERGY AND ASTHMA CENTER OF CENTRAL MD

Facility Address:
9891 BROKEN LAND PKWY #100
COLUMBIA, MD
ZIP 21046
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Facility Phone Number: 410 730-6000

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1487859492

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name Field Value
CLIA Number 21D2242089
LAB Type Physician Office
Facility Name ALLERGY AND ASTHMA CENTER OF CENTRAL MD
Street 9891 BROKEN LAND PKWY #100
City COLUMBIA
State MD
ZIP 21046
Phone 410 730-6000
CertificateType 4
CertificateEffectiveDate 11/4/2023
CertificateExpirationDate 11/3/2025
FacilityType Waiver

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