22D0075580 CLIA NUMBER - DHIRENDRA S BANA MD

Laboratory Demographics

  • CLIA Code: 22D0075580
  • Facility Name: DHIRENDRA S BANA MD
  • Facility Address: 19 ALHAMBRA ROAD
    WEST ROXBURY, MA
    ZIP 02132
  • Facility Phone: 617 524-3700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DHIRENDRA S. BANA
  • NPI Number: 1639134323
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 22D0075580
LAB Type Physician Office
Facility Name DHIRENDRA S BANA MD
Street 19 ALHAMBRA ROAD
City WEST ROXBURY
State MA
ZIP 02132
Phone 617 524-3700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DHIRENDRA S. BANA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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