BRADDOCK MEDICAL GROUP LABORATORY
NPI 1104901313
Clinical Medical Laboratory in Cumberland, MD

Active since October 26, 2006CLIA 21D0692067 · Microscopy
912 SETON DR, CUMBERLAND, MD 21502(301) 722-3111(301) 722-5135 Get Directions Write a Review

NPPES record last updated: September 16, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Braddock Medical Group Laboratory NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADDOCK MEDICAL GROUP LABORATORY (NPI 1104901313) is a healthcare organization registered as a clinical medical laboratory in Cumberland, Maryland and active in the NPI registry since October 2006. The organization holds a CLIA Microscopy certificate valid through February 5, 2027 and lists Thomas E Chappell, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1104901313
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameBRADDOCK MEDICAL GROUP
Location Address912 SETON DRCumberland, MD 21502-1818
Mailing Address912 Seton DrCumberland, MD 21502-1818 · (301) 722-3111 · Fax (301) 722-5135
Fax(301) 722-5135
Organization SubpartNo
Authorized OfficialThomas E ChappellMedical Director · (301) 722-3111
Enumeration DateOctober 26, 2006
Last NPPES UpdateSeptember 16, 2008
NPI 1104901313 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in MD · 830420
Definition
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.
912 SETON DR, Cumberland, MD 21502

Other Names 1

Other NameBraddock Medical Group Laboratory

Other Identifiers 1

Medicaid0011509001WV

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 21D0692067

Braddock Medical Group · Cumberland, MD
Active · expires Feb 5, 2027
CLIA Number21D0692067
Laboratory TypePhysician Office
Certificate Effective DateFebruary 6, 2025
Certificate Expiration DateFebruary 5, 2027
Laboratory DirectorPaul T. Livengood
Laboratory Phone(301) 722-3111
Laboratory LocationBraddock Medical Group912 Seton Drive, Cumberland, MD 21502
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
912 SETON DR
CUMBERLAND, MD 21502
Family Medicine
912 SETON DR
CUMBERLAND, MD 21502
Nurse Practitioner (Family)
912 SETON DR
CUMBERLAND, MD 21502
Internal Medicine
912 SETON DR
CUMBERLAND, MD 21502
Nurse Practitioner (Family)
912 SETON DR
CUMBERLAND, MD 21502
Clinic/Center (Primary Care)
912 SETON DR
CUMBERLAND, MD 21502

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Braddock Medical Group's NPI number?

The NPI number for Braddock Medical Group is 1104901313. It was assigned to this organization in the NPPES registry on October 26, 2006. The provider is also known as Braddock Medical Group Laboratory.

Where is Braddock Medical Group located?

Braddock Medical Group is located at 912 Seton Dr, Cumberland, MD 21502. The listed phone number is (301) 722-3111.

What is Braddock Medical Group's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

Does Braddock Medical Group hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 21D0692067) is associated with this NPI, valid through February 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Braddock Medical Group was last updated on September 16, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.