22D0077574 CLIA NUMBER - MASS GENERAL BRIGHAM COMMUNITY PHYSICIANS, INC

Laboratory Demographics

  • CLIA Code: 22D0077574
  • Facility Name: MASS GENERAL BRIGHAM COMMUNITY PHYSICIANS, INC
  • Facility Address: 101 MAIN ST STE 110
    MEDFORD, MA
    ZIP 02155
  • Facility Phone: 781 396-4514
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID PLADZIEWICZ
  • NPI Number: 1548638265
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 22D0077574
LAB Type Physician Office
Facility Name MASS GENERAL BRIGHAM COMMUNITY PHYSICIANS, INC
Street 101 MAIN ST STE 110
City MEDFORD
State MA
ZIP 02155
Phone 781 396-4514
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 DAVID PLADZIEWICZ

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