22D0703162 CLIA NUMBER - PHYSICIAN CARE WEST/REDA H ISHAK MD

Laboratory Demographics

  • CLIA Code: 22D0703162
  • Facility Name: PHYSICIAN CARE WEST/REDA H ISHAK MD
  • Facility Address: 112 WESTFIELD STREET #2
    W SPRINGFIELD, MA
    ZIP 01089
  • Facility Phone: 413 733-1900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROLAND STEBBINS
  • NPI Number: 1760594493
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 22D0703162
LAB Type Physician Office
Facility Name PHYSICIAN CARE WEST/REDA H ISHAK MD
Street 112 WESTFIELD STREET #2
City W SPRINGFIELD
State MA
ZIP 01089
Phone 413 733-1900
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 ROLAND STEBBINS

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