22D0068201 CLIA NUMBER - SUBURBAN INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 22D0068201
  • Facility Name: SUBURBAN INTERNAL MEDICINE
  • Facility Address: STOCKBRIDGE RD PO BOX 709
    LEE, MA
    ZIP 01238
  • Facility Phone: 413 243-0122
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: THOMAS A. CONSOLATI MD
  • NPI Number: 1659381192
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 22D0068201
LAB Type Physician Office
Facility Name SUBURBAN INTERNAL MEDICINE
Street STOCKBRIDGE RD PO BOX 709
City LEE
State MA
ZIP 01238
Phone 413 243-0122
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description 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.
Certificate Effective Date 5/9/2025
Certificate Expiration Date 5/8/2027
Facility Type Physician Office
Lab Director THOMAS A. CONSOLATI MD

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