22D0931864 CLIA NUMBER - CAPE COD PEDIATRICS

Laboratory Demographics

  • CLIA Code: 22D0931864
  • Facility Name: CAPE COD PEDIATRICS
  • Facility Address: 55 RT 130
    FORESTDALE, MA
    ZIP 02644
  • Facility Phone: 508 477-5306
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ROSHANN L. HOOSHMAND
  • NPI Number: 1053423087
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 22D0931864
LAB Type Physician Office
Facility Name CAPE COD PEDIATRICS
Street 55 RT 130
City FORESTDALE
State MA
ZIP 02644
Phone 508 477-5306
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/6/2025
Certificate Expiration Date 8/5/2027
Facility Type Physician Office
Lab Director DR. ROSHANN L. HOOSHMAND

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