21D2139615 CLIA NUMBER - MATCLINIC PHYSICIANS PRACTICE GROUP, LLC

Laboratory Demographics

  • CLIA Code: 21D2139615
  • Facility Name: MATCLINIC PHYSICIANS PRACTICE GROUP, LLC
  • Facility Address: 40 S DUNDALK AVE SUITE 400
    DUNDALK, MD
    ZIP 21222
  • Facility Phone: 410 302-1296
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ENRIQUE OVIEDO
  • NPI Number: 1063904985
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 21D2139615
LAB Type Physician Office
Facility Name MATCLINIC PHYSICIANS PRACTICE GROUP, LLC
Street 40 S DUNDALK AVE SUITE 400
City DUNDALK
State MD
ZIP 21222
Phone 410 302-1296
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Physician Office
Lab Director ENRIQUE OVIEDO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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