21D2255062 CLIA NUMBER - MIDDLE RIVER HEALTHCARE, LLC

Laboratory Demographics

  • CLIA Code: 21D2255062
  • Facility Name: MIDDLE RIVER HEALTHCARE, LLC
  • Facility Address: 621 STEMMERS RUN RD STE B
    ESSEX, MD
    ZIP 21221
  • Facility Phone: 443 492-2300
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JATU S. KARPEH
  • NPI Number: 1114682432
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2255062
LAB Type Practitioner Other
Facility Name MIDDLE RIVER HEALTHCARE, LLC
Street 621 STEMMERS RUN RD STE B
City ESSEX
State MD
ZIP 21221
Phone 443 492-2300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Practitioner Other
Lab Director JATU S. KARPEH

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