22D1026054 CLIA NUMBER - SOUTHCOAST PHYSICIANS GROUP FAMILY MEDICINE GROUP

Laboratory Demographics

CLIA Number: 22D1026054

Facility Name: SOUTHCOAST PHYSICIANS GROUP FAMILY MEDICINE GROUP

Facility Address:
1030 PRESIDENT AVE SUITE 1004
FALL RIVER, MA
ZIP 02720
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Facility Phone Number: 508 973-9600

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1346634052

Taxonomy: 207RG0100X - Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

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	508 973-9600
CertificateType	4
CertificateEffectiveDate	8/18/2022
CertificateExpirationDate	8/17/2024
FacilityType	Waiver

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