22D1026054 CLIA NUMBER - SOUTHCOAST PHYSICIANS GROUP FAMILY MEDICINE GROUP

Laboratory Demographics

  • CLIA Code: 22D1026054
  • Facility Name: SOUTHCOAST PHYSICIANS GROUP FAMILY MEDICINE GROUP
  • Facility Address: 1030 PRESIDENT AVE SUITE 1004
    FALL RIVER, MA
    ZIP 02720
  • Facility Phone: (508) 973-9600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SALTER D. JASON
  • NPI Number: 1346634052
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 22D1026054
LAB Type Physician Office
Facility Name SOUTHCOAST PHYSICIANS GROUP FAMILY MEDICINE GROUP
Street 1030 PRESIDENT AVE SUITE 1004
City FALL RIVER
State MA
ZIP 02720
Phone 5089739600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2024
Certificate Expiration Date 8/17/2026
Facility Type Physician Office
Lab Director SALTER D. JASON

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This page was last updated on: 5/18/2026