22D0074874 CLIA NUMBER - ALTHAUSEN-MC GOVERN ASSOCIATES

Laboratory Demographics

CLIA Number: 22D0074874

Facility Name: ALTHAUSEN-MC GOVERN ASSOCIATES

Facility Address:
1 HAWTHORNE PL SUITE 109
BOSTON, MA
ZIP 02114
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Facility Phone Number: 617 726-3559

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1710020656

Taxonomy: 208800000X - Urology
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

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	617 726-3559
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024