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22D0683548 CLIA NUMBER - UPHAMS CORNER HEALTH CENTER

Laboratory Demographics

CLIA Number: 22D0683548

Facility Name: UPHAMS CORNER HEALTH CENTER

Facility Address:
415 COLUMBIA ROAD
DORCHESTER, MA
ZIP 02125
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Facility Phone Number: 617 287-8000

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy
NPI Number: 1316023195

Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization
A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights.

CLIA Record

Field Name Field Value
CLIA Number 22D0683548
LAB Type Federally Qualified Health Center
Facility Name UPHAMS CORNER HEALTH CENTER
Street 415 COLUMBIA ROAD
City DORCHESTER
State MA
ZIP 02125
Phone 617 287-8000
CertificateType 3
CertificateEffectiveDate 1/5/2023
CertificateExpirationDate 1/4/2025
FacilityType PPMP

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This page was last updated on: 4/23/2024