21D2151446 CLIA NUMBER - MD MATT LLC

Laboratory Demographics

CLIA Number: 21D2151446

Facility Name: MD MATT LLC

Facility Address:
10220 S DOLFIELDS RD #106
OWINGS MILLS, MD
ZIP 21117
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Facility Phone Number: (443) 559-4137

Facility Type: OTHER PRACTITIONER

Certificate Type: Waiver

NPI Number: 1356857395

Taxonomy: 261QM0850X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

CLIA Record

Field Name	Field Value
CLIA Number	21D2151446
LAB Type	OTHER PRACTITIONER
Facility Name	MD MATT LLC
Street	10220 S DOLFIELDS RD #106
City	OWINGS MILLS
State	MD
ZIP	21117
Phone	(443) 559-4137

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This page was last updated on: 5/11/2023