22D0698866 CLIA NUMBER - SALLY S ROTH MD

Laboratory Demographics

  • CLIA Code: 22D0698866
  • Facility Name: SALLY S ROTH MD
  • Facility Address: 637 WASHINGTON STREET
    BROOKLINE, MA
    ZIP 02446
  • Facility Phone: 617 232-2811
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SALLY S. ROTH
  • NPI Number: 1558370999
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 22D0698866
LAB Type Physician Office
Facility Name SALLY S ROTH MD
Street 637 WASHINGTON STREET
City BROOKLINE
State MA
ZIP 02446
Phone 617 232-2811
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Physician Office
Lab Director SALLY S. ROTH

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