09D2005356 CLIA NUMBER - MC MEDICAL GROUP OF DC, PC CLINIC 00022

Laboratory Demographics

  • CLIA Code: 09D2005356
  • Facility Name: MC MEDICAL GROUP OF DC, PC CLINIC 00022
  • Facility Address: 320 40TH STREET NORTHEAST
    WASHINGTON, DC
    ZIP 20019
  • Facility Phone: 866 389-2727
  • Facility Type: Other - HEALTH CARE CLINIC
  • Facility Type: Waiver
  • Lab Director: LINDA DUQUETTE PETERSEN
  • NPI Number: 1841228947
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 09D2005356
LAB Type Other - HEALTH CARE CLINIC
Facility Name MC MEDICAL GROUP OF DC, PC CLINIC 00022
Street 320 40TH STREET NORTHEAST
City WASHINGTON
State DC
ZIP 20019
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2024
Certificate Expiration Date 3/24/2026
Facility Type Other - HEALTH CARE CLINIC
Lab Director LINDA DUQUETTE PETERSEN

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