22D0716890 CLIA NUMBER - BASS RIVER PEDIATRIC ASSOCIATES PC

Laboratory Demographics

  • CLIA Code: 22D0716890
  • Facility Name: BASS RIVER PEDIATRIC ASSOCIATES PC
  • Facility Address: 237 STATION AVENUE
    SOUTH YARMOUTH, MA
    ZIP 02664
  • Facility Phone: 508 394-2116
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENNETH COLMER
  • NPI Number: 1811105539
  • Taxonomy: 2080H0002X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 22D0716890
LAB Type Physician Office
Facility Name BASS RIVER PEDIATRIC ASSOCIATES PC
Street 237 STATION AVENUE
City SOUTH YARMOUTH
State MA
ZIP 02664
Phone 508 394-2116
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2025
Certificate Expiration Date 7/15/2027
Facility Type Physician Office
Lab Director KENNETH COLMER

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