21D2213793 CLIA NUMBER - WOLF MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 21D2213793
  • Facility Name: WOLF MEDICAL GROUP
  • Facility Address: 101 COLONIAL WAY SUITE B
    RISING SUN, MD
    ZIP 21911
  • Facility Phone: 443 485-9116
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT J. WOLF
  • NPI Number: 1205440153
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2213793
LAB Type Physician Office
Facility Name WOLF MEDICAL GROUP
Street 101 COLONIAL WAY SUITE B
City RISING SUN
State MD
ZIP 21911
Phone 443 485-9116
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2025
Certificate Expiration Date 2/16/2027
Facility Type Physician Office
Lab Director ROBERT J. WOLF

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