22D1004757 CLIA NUMBER - MARLBOROUGH INTERNAL MEDICINE PC

Laboratory Demographics

  • CLIA Code: 22D1004757
  • Facility Name: MARLBOROUGH INTERNAL MEDICINE PC
  • Facility Address: 65 FREMONT ST
    MARLBORO, MA
    ZIP 01752
  • Facility Phone: 508 303-8553
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LALITA A. MATTA
  • NPI Number: 1477764116
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 22D1004757
LAB Type Physician Office
Facility Name MARLBOROUGH INTERNAL MEDICINE PC
Street 65 FREMONT ST
City MARLBORO
State MA
ZIP 01752
Phone 508 303-8553
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2024
Certificate Expiration Date 10/3/2026
Facility Type Physician Office
Lab Director LALITA A. MATTA

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