21D2267230 CLIA NUMBER - MD MATT LLC

Laboratory Demographics

  • CLIA Code: 21D2267230
  • Facility Name: MD MATT LLC
  • Facility Address: 309 E PATRICK ST
    FREDERICK, MD
    ZIP 21701
  • Facility Phone: 443 559-2170
  • Facility Type: Other - NP OFFICE
  • Facility Type: Waiver
  • Lab Director: NJIDEKA EMENYI
  • NPI Number: 1619583200
  • Taxonomy: 363LA2200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2267230
LAB Type Other - NP OFFICE
Facility Name MD MATT LLC
Street 309 E PATRICK ST
City FREDERICK
State MD
ZIP 21701
Phone 443 559-2170
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2024
Certificate Expiration Date 8/22/2026
Facility Type Other - NP OFFICE
Lab Director NJIDEKA EMENYI

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