21D2295462 CLIA NUMBER - EASTERN SHORE PRIMARY CARE & WELLNESS

Laboratory Demographics

  • CLIA Code: 21D2295462
  • Facility Name: EASTERN SHORE PRIMARY CARE & WELLNESS
  • Facility Address: 1505 S SALISBURY BLVD
    SALISBURY, MD
    ZIP 21801
  • Facility Phone: 410 936-5500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARTIN A. MELSON JR
  • NPI Number: 1285404699
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2295462
LAB Type Physician Office
Facility Name EASTERN SHORE PRIMARY CARE & WELLNESS
Street 1505 S SALISBURY BLVD
City SALISBURY
State MD
ZIP 21801
Phone 410 936-5500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2023
Certificate Expiration Date 12/11/2025
Facility Type Physician Office
Lab Director MARTIN A. MELSON JR

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