CLIA lab
CLIA 21D0874555: Autumn Lake Healthcare at Long Green
Baltimore, MD. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 21D0874555 belongs to Autumn Lake Healthcare at Long Green in Baltimore, MD.
Certificate of Waiver, effective August 11, 2025, expires August 10, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- August 11, 2025
- Certificate expiration
- August 10, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 11, 1993
- Facility type
- Skilled nursing or nursing facility
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 21D0874555
- Lab name
- Autumn Lake Healthcare at Long Green
- Address
- 115 E Melrose Avenue, Baltimore, MD 21212
- Phone
- (410) 435-9073
Annual test volume the lab reported
- Waived tests
- 900
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Care facility at this address
- Autumn Lake Healthcare at Long GreenCMS Care Compare ratings for the facility at the same street address
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Related
Questions
What is the CLIA number for Autumn Lake Healthcare at Long Green in Baltimore?
21D0874555, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Autumn Lake Healthcare at Long Green hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 21D0874555 expire?
The CMS file lists August 10, 2027 as the certificate expiration date; the certificate took effect August 11, 2025.