22D0868478 CLIA NUMBER - SOUTHCOAST HEALTH URGENT CARE CENTER

Laboratory Demographics

  • CLIA Code: 22D0868478
  • Facility Name: SOUTHCOAST HEALTH URGENT CARE CENTER
  • Facility Address: 208 MILL ROAD
    FAIRHAVEN, MA
    ZIP 02719
  • Facility Phone: 855 319-0518
  • Facility Type: Other - URGENT CARE CENTER
  • Facility Type: Waiver
  • Lab Director: SUSRUTA PRUSTY
  • NPI Number: 1861830143
  • Taxonomy: 207P00000X - Emergency Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 22D0868478
LAB Type Other - URGENT CARE CENTER
Facility Name SOUTHCOAST HEALTH URGENT CARE CENTER
Street 208 MILL ROAD
City FAIRHAVEN
State MA
ZIP 02719
Phone 855 319-0518
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2024
Certificate Expiration Date 4/30/2026
Facility Type Other - URGENT CARE CENTER
Lab Director SUSRUTA PRUSTY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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