22D0703159 CLIA NUMBER - PEDIATRIC PROFESSIONAL ASSOCIATES PC

Laboratory Demographics

  • CLIA Code: 22D0703159
  • Facility Name: PEDIATRIC PROFESSIONAL ASSOCIATES PC
  • Facility Address: 413 BROADWAY
    METHUEN, MA
    ZIP 01844
  • Facility Phone: 508 683-1974
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID A. AVILA DO
  • NPI Number: 1225158405
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 22D0703159
LAB Type Physician Office
Facility Name PEDIATRIC PROFESSIONAL ASSOCIATES PC
Street 413 BROADWAY
City METHUEN
State MA
ZIP 01844
Phone 508 683-1974
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director DAVID A. AVILA DO

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