22D0075996 CLIA NUMBER - RESERVOIR MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 22D0075996
  • Facility Name: RESERVOIR MEDICAL ASSOCIATES
  • Facility Address: 725 CONCORD AVE
    CAMBRIDGE, MA
    ZIP 02138
  • Facility Phone: 617 661-4600
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DEBRA S. SHAPIRO
  • NPI Number: 1356399562
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 22D0075996
LAB Type Physician Office
Facility Name RESERVOIR MEDICAL ASSOCIATES
Street 725 CONCORD AVE
City CAMBRIDGE
State MA
ZIP 02138
Phone 617 661-4600
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 7/21/2025
Certificate Expiration Date 7/20/2027
Facility Type Physician Office
Lab Director DEBRA S. SHAPIRO

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