21D2231417 CLIA NUMBER - MATCLINIC PHYSICIAN PRACTICE GROUP LLC

Laboratory Demographics

  • CLIA Code: 21D2231417
  • Facility Name: MATCLINIC PHYSICIAN PRACTICE GROUP LLC
  • Facility Address: 659 S SALISBURY BLVD
    SALISBURY, MD
    ZIP 21801
  • Facility Phone: 443 904-6285
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ENRIQUE J. OVIEDO
  • NPI Number: 1225608391
  • Taxonomy: 207RA0401X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2231417
LAB Type Physician Office
Facility Name MATCLINIC PHYSICIAN PRACTICE GROUP LLC
Street 659 S SALISBURY BLVD
City SALISBURY
State MD
ZIP 21801
Phone 443 904-6285
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/3/2025
Certificate Expiration Date 8/2/2027
Facility Type Physician Office
Lab Director DR. ENRIQUE J. OVIEDO

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