22D0931935 CLIA NUMBER - NORFOLK CENTER FOR CANCER CARE AND HEMATOLOGY

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Laboratory Demographics

CLIA Number: 22D0931935

Facility Name: NORFOLK CENTER FOR CANCER CARE AND HEMATOLOGY

Facility Address:
1073 PLEASANT STREET
BROCKTON, MA
ZIP 02301
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Facility Phone Number: 508 427-5599

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1124193891

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name	Field Value
CLIA Number	22D0931935
LAB Type	Physician Office
Facility Name	NORFOLK CENTER FOR CANCER CARE AND HEMATOLOGY
Street	1073 PLEASANT STREET
City	BROCKTON
State	MA
ZIP	02301
Phone	508 427-5599
CertificateType	2
CertificateEffectiveDate	12/27/2023
CertificateExpirationDate	12/26/2025
FacilityType	Compliance

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This page was last updated on: 4/23/2024