22D0967886 CLIA NUMBER - CARMEL KELLY, MD, COMMUNITY PHYS ASSOC

Laboratory Demographics

  • CLIA Code: 22D0967886
  • Facility Name: CARMEL KELLY, MD, COMMUNITY PHYS ASSOC
  • Facility Address: 1093 NORTH MAIN STREET
    RANDOLPH, MA
    ZIP 02368
  • Facility Phone: 617 696-4600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM J. O'BRIEN
  • NPI Number: 1164416228
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 22D0967886
LAB Type Physician Office
Facility Name CARMEL KELLY, MD, COMMUNITY PHYS ASSOC
Street 1093 NORTH MAIN STREET
City RANDOLPH
State MA
ZIP 02368
Phone 617 696-4600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/26/2023
Certificate Expiration Date 11/25/2025
Facility Type Physician Office
Lab Director WILLIAM J. O'BRIEN

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