21D2277656 CLIA NUMBER - LOTUS RECOVERY CENTER INC

Laboratory Demographics

  • CLIA Code: 21D2277656
  • Facility Name: LOTUS RECOVERY CENTER INC
  • Facility Address: 4207 SPRINGWOOD AVE
    BALTIMORE, MD
    ZIP 21206
  • Facility Phone: 443 707-5558
  • Facility Type: Other - ASAM 3.1 RESIDENTIAL TX
  • Facility Type: Waiver
  • Lab Director: JESSE WATERMAN
  • NPI Number: 1861110090
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 21D2277656
LAB Type Other - ASAM 3.1 RESIDENTIAL TX
Facility Name LOTUS RECOVERY CENTER INC
Street 4207 SPRINGWOOD AVE
City BALTIMORE
State MD
ZIP 21206
Phone 443 707-5558
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2025
Certificate Expiration Date 3/1/2027
Facility Type Other - ASAM 3.1 RESIDENTIAL TX
Lab Director JESSE WATERMAN

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