21D2297784 CLIA NUMBER - MD MATT LLC

Laboratory Demographics

  • CLIA Code: 21D2297784
  • Facility Name: MD MATT LLC
  • Facility Address: 265 MILL ST #700
    HAGERSTOWN, MD
    ZIP 21740
  • Facility Phone: 443 220-6122
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CALANDRA HARDING
  • NPI Number: 1508636762
  • Taxonomy: 363LA2200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 21D2297784
LAB Type Practitioner Other
Facility Name MD MATT LLC
Street 265 MILL ST #700
City HAGERSTOWN
State MD
ZIP 21740
Phone 443 220-6122
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2024
Certificate Expiration Date 1/22/2026
Facility Type Practitioner Other
Lab Director CALANDRA HARDING

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