A certificate of need is required before an ambulatory care facility: Offers any health service: Through a health care facility; In space leased from a health care facility; or In space on land leased from a health care facility; To provide those services, makes an expenditure, if a certificate of need would be required under § 19-120(k) of this subtitle for the expenditure by or on behalf of a health care facility; or Does anything else for which the federal act requires a certificate of need and that the Commission has not exempted from that requirement.