22D0080571 CLIA NUMBER - BOURNE MANOR EXTENDED CARE FACILITY

Laboratory Demographics

  • CLIA Code: 22D0080571
  • Facility Name: BOURNE MANOR EXTENDED CARE FACILITY
  • Facility Address: 146 MACARTHUR BLVD
    BOURNE, MA
    ZIP 02532
  • Facility Phone: 508 759-8880
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: IRVING RESTITUYO
  • NPI Number: 1699910752
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 22D0080571
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BOURNE MANOR EXTENDED CARE FACILITY
Street 146 MACARTHUR BLVD
City BOURNE
State MA
ZIP 02532
Phone 508 759-8880
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 Skilled Nursing Facility/Nursing Facility
Lab Director IRVING RESTITUYO

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