WELLSPRING CLINIC LLC
NPI 1154788818
Clinic/Center - Medical Specialty in Bel Air, MD
- Organization
- Clinic/Center
- Medical Specialty
- CLIA Number: 21D2134266
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 08-25-2026
About WELLSPRING CLINIC LLC
This page provides the complete NPI Profile along with additional information for Wellspring Clinic Llc, a provider established in Bel Air, Maryland operating as a Clinic/center, focusing in medical specialty . The healthcare provider is registered in the NPI registry with number 1154788818 assigned on January 2016. The practitioner's primary taxonomy code is 261QM2500X with license number D63924 (MD). The provider is registered as an organization and their NPI record was last updated 7 years ago. The authorized official of this NPI record is Nkiruka Arene Md (Owner)
- NPI
- 1154788818 Verify this NPI
- Provider Name
- WELLSPRING CLINIC LLC
- Entity Type
- Organization
- Location Address
- 2012 S TOLLGATE RD STE 207 BEL AIR, MD 21015
- Location Phone
- (443) 371-9750
- Mailing Address
- 2012 S TOLLGATE RD SUITE 206 BEL AIR, MD 21015
- Mailing Phone
- (443) 977-9180
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-26-2016
- Last Update Date
- 07-12-2019
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Medical Specialty
- Taxonomy Code
- 261QM2500X
- Type
- Ambulatory Health Care Facilities
- License No.
- D63924
- License State
- MD
- Taxonomy Description
- An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 21D2134266
- Facility Type
- Physician Office
- Certificate Effective Date
- August 26, 2024
- Certificate Expiration Date
- August 25, 2026
- Laboratory Director
- YIBIN WANG
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Wellspring Clinic Llc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
BEL AIR, MD 21015
BEL AIR, MD 21015
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154788818, enumerated as an "organization" on January 26, 2016.
The provider is located at 2012 S TOLLGATE RD STE 207 BEL AIR, MD 21015 and the phone number is (443) 371-9750.
Clinic/Center with taxonomy code 261QM2500X and a focus in Medical Specialty.
