21D2305689 CLIA NUMBER - EVERNORTH CARE PROVIDERS- DELAWARE PA

Laboratory Demographics

  • CLIA Code: 21D2305689
  • Facility Name: EVERNORTH CARE PROVIDERS- DELAWARE PA
  • Facility Address: 145 WEST OSTEND ST #600
    BALTIMORE, MD
    ZIP 21230
  • Facility Phone: 877 663-1333
  • Facility Type: Other - IN HOME PRIMARY CARE
  • Facility Type: Waiver
  • Lab Director: STEPHEN WALSH
  • NPI Number: 1063284032
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 21D2305689
LAB Type Other - IN HOME PRIMARY CARE
Facility Name EVERNORTH CARE PROVIDERS- DELAWARE PA
Street 145 WEST OSTEND ST #600
City BALTIMORE
State MD
ZIP 21230
Phone 877 663-1333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2024
Certificate Expiration Date 6/4/2026
Facility Type Other - IN HOME PRIMARY CARE
Lab Director STEPHEN WALSH

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