21D0976142 CLIA NUMBER - THOMAS HATTAR MD

Laboratory Demographics

  • CLIA Code: 21D0976142
  • Facility Name: THOMAS HATTAR MD
  • Facility Address: 617 RIDGELY AVE
    ANNAPOLIS, MD
    ZIP 21401
  • Facility Phone: 410 224-7615
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: THOMAS HATTAR MD
  • NPI Number: 1154438497
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D0976142
LAB Type Physician Office
Facility Name THOMAS HATTAR MD
Street 617 RIDGELY AVE
City ANNAPOLIS
State MD
ZIP 21401
Phone 410 224-7615
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 7/26/2024
Certificate Expiration Date 7/25/2026
Facility Type Physician Office
Lab Director THOMAS HATTAR MD

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