21D1011197 CLIA NUMBER - MEDSTAR MEDICAL GROUP

Laboratory Demographics

CLIA Number: 21D1011197

Facility Name: MEDSTAR MEDICAL GROUP

Facility Address:
18111 PRINCE PHILIP DRIVE STE 207
OLNEY, MD
ZIP 20832
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Facility Phone Number: 301 774-7170

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1053874321

Taxonomy: 2084P0800X - Psychiatry & Neurology
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

CLIA Record

Field Name	Field Value
CLIA Number	21D1011197
LAB Type	Physician Office
Facility Name	MEDSTAR MEDICAL GROUP
Street	18111 PRINCE PHILIP DRIVE STE 207
City	OLNEY
State	MD
ZIP	20832
Phone	301 774-7170
CertificateType	4
CertificateEffectiveDate	4/3/2023
CertificateExpirationDate	4/2/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024