21D2132816 CLIA NUMBER - MATTHEW MINTZ MD LLC

Laboratory Demographics

  • CLIA Code: 21D2132816
  • Facility Name: MATTHEW MINTZ MD LLC
  • Facility Address: 6000 EXECUTIVE BLVD #315
    ROCKVILLE, MD
    ZIP 20852
  • Facility Phone: 855 646-8963
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MATTHEW L. MINTZ
  • NPI Number: 1063584951
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2132816
LAB Type Physician Office
Facility Name MATTHEW MINTZ MD LLC
Street 6000 EXECUTIVE BLVD #315
City ROCKVILLE
State MD
ZIP 20852
Phone 855 646-8963
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2025
Certificate Expiration Date 6/27/2027
Facility Type Physician Office
Lab Director MATTHEW L. MINTZ

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