21D2283011 CLIA NUMBER - BALTIMORE DETOX CENTER LLC

Laboratory Demographics

  • CLIA Code: 21D2283011
  • Facility Name: BALTIMORE DETOX CENTER LLC
  • Facility Address: 1825 WOODLAWN DRIVE
    WOODLAWN, MD
    ZIP 21207
  • Facility Phone: 301 991-9718
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: JEANETTE MITCHELL
  • NPI Number: 1275115495
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 21D2283011
LAB Type Hospital
Facility Name BALTIMORE DETOX CENTER LLC
Street 1825 WOODLAWN DRIVE
City WOODLAWN
State MD
ZIP 21207
Phone 301 991-9718
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/31/2025
Certificate Expiration Date 5/30/2027
Facility Type Hospital
Lab Director JEANETTE MITCHELL

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