22D0877158 CLIA NUMBER - SUDBURY PINES EXTENDED CARE FACILITY

Laboratory Demographics

  • CLIA Code: 22D0877158
  • Facility Name: SUDBURY PINES EXTENDED CARE FACILITY
  • Facility Address: 642 BOSTON POST ROAD
    SUDBURY, MA
    ZIP 01776
  • Facility Phone: 508 443-9000
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ALEXIS C. KEOHAN
  • NPI Number: 1811024664
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 22D0877158
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name SUDBURY PINES EXTENDED CARE FACILITY
Street 642 BOSTON POST ROAD
City SUDBURY
State MA
ZIP 01776
Phone 508 443-9000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2025
Certificate Expiration Date 9/28/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ALEXIS C. KEOHAN

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