21D0963607 CLIA NUMBER - MATTHEW J MALTA MD PA

Laboratory Demographics

  • CLIA Code: 21D0963607
  • Facility Name: MATTHEW J MALTA MD PA
  • Facility Address: 132 HOLIDAY COURT STE 201
    ANNAPOLIS, MD
    ZIP 21403
  • Facility Phone: 410 263-0770
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MATTHEW J. MALTA MD
  • NPI Number: 1750422549
  • Taxonomy: 363AS0400X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 21D0963607
LAB Type Physician Office
Facility Name MATTHEW J MALTA MD PA
Street 132 HOLIDAY COURT STE 201
City ANNAPOLIS
State MD
ZIP 21403
Phone 410 263-0770
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/3/2025
Certificate Expiration Date 8/2/2027
Facility Type Physician Office
Lab Director MATTHEW J. MALTA MD

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