21D1076517 CLIA NUMBER - URBANA GI ENDOSCOPY CENTER LLC

Laboratory Demographics

  • CLIA Code: 21D1076517
  • Facility Name: URBANA GI ENDOSCOPY CENTER LLC
  • Facility Address: 3280 URBANA PIKE SUITE 104
    IJAMSVILLE, MD
    ZIP 21754
  • Facility Phone: 410 218-7767
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MARK S. GLOGER
  • NPI Number: 1821115700
  • Taxonomy: 261QE0800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 21D1076517
LAB Type Ambulatory Surgery Center
Facility Name URBANA GI ENDOSCOPY CENTER LLC
Street 3280 URBANA PIKE SUITE 104
City IJAMSVILLE
State MD
ZIP 21754
Phone 410 218-7767
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2023
Certificate Expiration Date 11/15/2025
Facility Type Ambulatory Surgery Center
Lab Director MARK S. GLOGER

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This page was last updated on: 3/20/2025