21D2297104 CLIA NUMBER - THE FREEDOM CENTER LLC

Laboratory Demographics

  • CLIA Code: 21D2297104
  • Facility Name: THE FREEDOM CENTER LLC
  • Facility Address: 3521 BUCKEYSTOWN PIKE PO BOX 324
    BUCKEYSTOWN, MD
    ZIP 21717
  • Facility Phone: 240 751-3989
  • Facility Type: Other - SUBSTANCE ABUSE FACILITY
  • Facility Type: Waiver
  • Lab Director: MARK ILLUMINATI
  • NPI Number: 1770060600
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 21D2297104
LAB Type Other - SUBSTANCE ABUSE FACILITY
Facility Name THE FREEDOM CENTER LLC
Street 3521 BUCKEYSTOWN PIKE PO BOX 324
City BUCKEYSTOWN
State MD
ZIP 21717
Phone 240 751-3989
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2024
Certificate Expiration Date 1/9/2026
Facility Type Other - SUBSTANCE ABUSE FACILITY
Lab Director MARK ILLUMINATI

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