21D2312941 CLIA NUMBER - BALTIMORE CO EMPLOYEE HEALTH CTR DBA EVERNORTH DIR

Laboratory Demographics

  • CLIA Code: 21D2312941
  • Facility Name: BALTIMORE CO EMPLOYEE HEALTH CTR DBA EVERNORTH DIR
  • Facility Address: 305 WASHINGTON AVENUE SUITE 101
    TOWSON, MD
    ZIP 21204
  • Facility Phone: 480 868-0646
  • Facility Type: Other - OUTPATIENT
  • Facility Type: Waiver
  • Lab Director: AMANDA HARNER
  • NPI Number: 1124042577
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 21D2312941
LAB Type Other - OUTPATIENT
Facility Name BALTIMORE CO EMPLOYEE HEALTH CTR DBA EVERNORTH DIR
Street 305 WASHINGTON AVENUE SUITE 101
City TOWSON
State MD
ZIP 21204
Phone 480 868-0646
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Other - OUTPATIENT
Lab Director AMANDA HARNER

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