22D1030458 CLIA NUMBER - NAUSET FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 22D1030458
  • Facility Name: NAUSET FAMILY PRACTICE
  • Facility Address: 81 OLD COLONY WAY SUITE D
    ORLEANS, MA
    ZIP 02653
  • Facility Phone: 508 240-1141
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIM MEAD WALTERS
  • NPI Number: 1760411482
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 22D1030458
LAB Type Physician Office
Facility Name NAUSET FAMILY PRACTICE
Street 81 OLD COLONY WAY SUITE D
City ORLEANS
State MA
ZIP 02653
Phone 508 240-1141
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/7/2024
Certificate Expiration Date 9/6/2026
Facility Type Physician Office
Lab Director KIM MEAD WALTERS

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