21D2242090 CLIA NUMBER - DUNDALK MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 21D2242090
  • Facility Name: DUNDALK MEDICAL GROUP
  • Facility Address: 207 WISE AVENUE
    DUNDALK, MD
    ZIP 21222
  • Facility Phone: 410 284-1004
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DEEPAK SETH
  • NPI Number: 1619514049
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 21D2242090
LAB Type Physician Office
Facility Name DUNDALK MEDICAL GROUP
Street 207 WISE AVENUE
City DUNDALK
State MD
ZIP 21222
Phone 410 284-1004
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2023
Certificate Expiration Date 11/3/2025
Facility Type Physician Office
Lab Director DEEPAK SETH

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