21D2253574 CLIA NUMBER - RESTORING MINDS BEHAVIORAL HEALTH SERVICES, LLC

Laboratory Demographics

  • CLIA Code: 21D2253574
  • Facility Name: RESTORING MINDS BEHAVIORAL HEALTH SERVICES, LLC
  • Facility Address: 1105 NORTH POINT BLVE SUITE 310
    BALTIMORE, MD
    ZIP 21224
  • Facility Phone: 443 943-0007
  • Facility Type: Other - OUTPATIENT SUD COUNSELING
  • Facility Type: Waiver
  • Lab Director: NICOLE L. SHELL
  • NPI Number: 1790453900
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 21D2253574
LAB Type Other - OUTPATIENT SUD COUNSELING
Facility Name RESTORING MINDS BEHAVIORAL HEALTH SERVICES, LLC
Street 1105 NORTH POINT BLVE SUITE 310
City BALTIMORE
State MD
ZIP 21224
Phone 443 943-0007
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Other - OUTPATIENT SUD COUNSELING
Lab Director NICOLE L. SHELL

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