22D0076428 CLIA NUMBER - DAVIS SQUARE FAMILY PRACTICE PC

Laboratory Demographics

  • CLIA Code: 22D0076428
  • Facility Name: DAVIS SQUARE FAMILY PRACTICE PC
  • Facility Address: 255 ELM ST STE 301
    SOMERVILLE, MA
    ZIP 02144
  • Facility Phone: 617 666-9577
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DEBORAH BERSHEL
  • NPI Number: 1780782409
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 22D0076428
LAB Type Physician Office
Facility Name DAVIS SQUARE FAMILY PRACTICE PC
Street 255 ELM ST STE 301
City SOMERVILLE
State MA
ZIP 02144
Phone 617 666-9577
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 7/12/2024
Certificate Expiration Date 7/11/2026
Facility Type Physician Office
Lab Director DEBORAH BERSHEL

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