21D2304545 CLIA NUMBER - AVERY ROAD COMBINED CARE

Laboratory Demographics

  • CLIA Code: 21D2304545
  • Facility Name: AVERY ROAD COMBINED CARE
  • Facility Address: 14701 AVERY ROAD
    ROCKVILLE, MD
    ZIP 20853
  • Facility Phone: 443 966-1047
  • Facility Type: Other - SUBSTANCE USE DISORDER TX
  • Facility Type: Waiver
  • Lab Director: MARC FISHMAN
  • NPI Number: 1619082005
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 21D2304545
LAB Type Other - SUBSTANCE USE DISORDER TX
Facility Name AVERY ROAD COMBINED CARE
Street 14701 AVERY ROAD
City ROCKVILLE
State MD
ZIP 20853
Phone 443 966-1047
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2024
Certificate Expiration Date 5/14/2026
Facility Type Other - SUBSTANCE USE DISORDER TX
Lab Director MARC FISHMAN

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