21D0975824 CLIA NUMBER - SEJAL G MATTU MD

Laboratory Demographics

  • CLIA Code: 21D0975824
  • Facility Name: SEJAL G MATTU MD
  • Facility Address: 2401 BRANDERMILL BLVD STE 220
    GAMBRILLS, MD
    ZIP 21054
  • Facility Phone: 410 451-7214
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SEJAL G. MATTU MD
  • NPI Number: 1538152004
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D0975824
LAB Type Physician Office
Facility Name SEJAL G MATTU MD
Street 2401 BRANDERMILL BLVD STE 220
City GAMBRILLS
State MD
ZIP 21054
Phone 410 451-7214
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/21/2024
Certificate Expiration Date 7/20/2026
Facility Type Physician Office
Lab Director SEJAL G. MATTU MD

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