21D2295944 CLIA NUMBER - MANAHYDRATION AND PHLEBOTOMY

Laboratory Demographics

  • CLIA Code: 21D2295944
  • Facility Name: MANAHYDRATION AND PHLEBOTOMY
  • Facility Address: 27 POWDERVIEW CT
    NOTTINGHAM, MD
    ZIP 21236
  • Facility Phone: 410 240-8231
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: NICOLE A. DORSEY
  • NPI Number: 1811758840
  • Taxonomy: 246RP1900X - Technician, Pathology

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CLIA Record

Field Name Field Value
CLIA Number 21D2295944
LAB Type Mobile Laboratory
Facility Name MANAHYDRATION AND PHLEBOTOMY
Street 27 POWDERVIEW CT
City NOTTINGHAM
State MD
ZIP 21236
Phone 410 240-8231
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2023
Certificate Expiration Date 12/18/2025
Facility Type Mobile Laboratory
Lab Director NICOLE A. DORSEY

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