21D2220432 CLIA NUMBER - MCCOY MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 21D2220432
  • Facility Name: MCCOY MEDICAL GROUP
  • Facility Address: 4 C NORTH AVE SUITE 403
    BEL AIR, MD
    ZIP 21014
  • Facility Phone: 410 638-2643
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. DEREK A. MCCOY
  • NPI Number: 1568179612
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2220432
LAB Type Practitioner Other
Facility Name MCCOY MEDICAL GROUP
Street 4 C NORTH AVE SUITE 403
City BEL AIR
State MD
ZIP 21014
Phone 410 638-2643
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Practitioner Other
Lab Director DR. DEREK A. MCCOY

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