22D0725729 CLIA NUMBER - MANHAN INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 22D0725729
  • Facility Name: MANHAN INTERNAL MEDICINE
  • Facility Address: 6 PARC PL SUITE A
    SOUTHAMPTON, MA
    ZIP 01073
  • Facility Phone: 413 529-9282
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK A. BIGDA
  • NPI Number: 1043590417
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 22D0725729
LAB Type Physician Office
Facility Name MANHAN INTERNAL MEDICINE
Street 6 PARC PL SUITE A
City SOUTHAMPTON
State MA
ZIP 01073
Phone 413 529-9282
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2025
Certificate Expiration Date 10/20/2027
Facility Type Physician Office
Lab Director MARK A. BIGDA

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