21D2260845 CLIA NUMBER - MID-ATLANTIC ENT, LLC

Laboratory Demographics

  • CLIA Code: 21D2260845
  • Facility Name: MID-ATLANTIC ENT, LLC
  • Facility Address: 600 RIDGELY AVE SUITE 110
    ANNAPOLIS, MD
    ZIP 21401
  • Facility Phone: 410 573-9191
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT MEEK
  • NPI Number: 1770175978
  • Taxonomy: 207Y00000X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 21D2260845
LAB Type Physician Office
Facility Name MID-ATLANTIC ENT, LLC
Street 600 RIDGELY AVE SUITE 110
City ANNAPOLIS
State MD
ZIP 21401
Phone 410 573-9191
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Physician Office
Lab Director ROBERT MEEK

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