22D0936777 CLIA NUMBER - SOUTHCOAST PHYSICIANS GROUP

Laboratory Demographics

  • CLIA Code: 22D0936777
  • Facility Name: SOUTHCOAST PHYSICIANS GROUP
  • Facility Address: 1601 SOUTH MAIN STREET
    FALL RIVER, MA
    ZIP 02724
  • Facility Phone: 508 678-0004
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN C. CARROLL
  • NPI Number: 1871915090
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 22D0936777
LAB Type Physician Office
Facility Name SOUTHCOAST PHYSICIANS GROUP
Street 1601 SOUTH MAIN STREET
City FALL RIVER
State MA
ZIP 02724
Phone 508 678-0004
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2024
Certificate Expiration Date 10/18/2026
Facility Type Physician Office
Lab Director JOHN C. CARROLL

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