22D0074874 CLIA NUMBER - ALTHAUSEN-MC GOVERN ASSOCIATES

Laboratory Demographics

  • CLIA Code: 22D0074874
  • Facility Name: ALTHAUSEN-MC GOVERN ASSOCIATES
  • Facility Address: 1 HAWTHORNE PL SUITE 109
    BOSTON, MA
    ZIP 02114
  • Facility Phone: (617) 726-3559
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ALEX F. ALTHAUSEN
  • NPI Number: 1710020656
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 22D0074874
LAB Type Physician Office
Facility Name ALTHAUSEN-MC GOVERN ASSOCIATES
Street 1 HAWTHORNE PL SUITE 109
City BOSTON
State MA
ZIP 02114
Phone 6177263559
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director ALEX F. ALTHAUSEN

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This page was last updated on: 5/18/2026