22D0073219 CLIA NUMBER - MARBLEHEAD PEDIATRICS

Laboratory Demographics

  • CLIA Code: 22D0073219
  • Facility Name: MARBLEHEAD PEDIATRICS
  • Facility Address: 70 ATLANTIC AVENUE
    MARBLEHEAD, MA
    ZIP 01945
  • Facility Phone: 781 631-7800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LISA A. GAST
  • NPI Number: 1386794584
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 22D0073219
LAB Type Physician Office
Facility Name MARBLEHEAD PEDIATRICS
Street 70 ATLANTIC AVENUE
City MARBLEHEAD
State MA
ZIP 01945
Phone 781 631-7800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2024
Certificate Expiration Date 1/26/2026
Facility Type Physician Office
Lab Director LISA A. GAST

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