22D0076438 CLIA NUMBER - SOMERVILLE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 22D0076438
  • Facility Name: SOMERVILLE FAMILY PRACTICE
  • Facility Address: 1020 BROADWAY
    SOMERVILLE, MA
    ZIP 02144
  • Facility Phone: 617 628-2160
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL WEMPLE
  • NPI Number: 1275089575
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 22D0076438
LAB Type Physician Office
Facility Name SOMERVILLE FAMILY PRACTICE
Street 1020 BROADWAY
City SOMERVILLE
State MA
ZIP 02144
Phone 617 628-2160
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2025
Certificate Expiration Date 9/17/2027
Facility Type Physician Office
Lab Director DANIEL WEMPLE

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