22D0069690 CLIA NUMBER - WORCESTER PEDIATRICS, PC

Laboratory Demographics

  • CLIA Code: 22D0069690
  • Facility Name: WORCESTER PEDIATRICS, PC
  • Facility Address: 123 SUMMER ST STE 690
    WORCESTER, MA
    ZIP 01608
  • Facility Phone: 508 363-9530
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAULETTE KIMBALL-WREN
  • NPI Number: 1740654599
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 22D0069690
LAB Type Physician Office
Facility Name WORCESTER PEDIATRICS, PC
Street 123 SUMMER ST STE 690
City WORCESTER
State MA
ZIP 01608
Phone 508 363-9530
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/12/2025
Certificate Expiration Date 1/11/2027
Facility Type Physician Office
Lab Director PAULETTE KIMBALL-WREN

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