22D0075910 CLIA NUMBER - HYDE PARK PEDIATRICS PC

Laboratory Demographics

  • CLIA Code: 22D0075910
  • Facility Name: HYDE PARK PEDIATRICS PC
  • Facility Address: 695 TRUMAN PARKWAY, SUITE 203
    HYDE PARK, MA
    ZIP 02136
  • Facility Phone: 617 361-1470
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELISABETH K. DIPIETRO
  • NPI Number: 1629144555
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 22D0075910
LAB Type Physician Office
Facility Name HYDE PARK PEDIATRICS PC
Street 695 TRUMAN PARKWAY, SUITE 203
City HYDE PARK
State MA
ZIP 02136
Phone 617 361-1470
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Physician Office
Lab Director ELISABETH K. DIPIETRO

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This page was last updated on: 6/4/2025