22D1030927 CLIA NUMBER - COMMONWEALTH OB-GYN, PC

Laboratory Demographics

  • CLIA Code: 22D1030927
  • Facility Name: COMMONWEALTH OB-GYN, PC
  • Facility Address: ONE BROOKLINE PLACE SUITE 305
    BROOKLINE, MA
    ZIP 02445
  • Facility Phone: 617 732-1510
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DERNA M. DEMAGGIO
  • NPI Number: 1912082694
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 22D1030927
LAB Type Physician Office
Facility Name COMMONWEALTH OB-GYN, PC
Street ONE BROOKLINE PLACE SUITE 305
City BROOKLINE
State MA
ZIP 02445
Phone 617 732-1510
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/21/2024
Certificate Expiration Date 9/20/2026
Facility Type Physician Office
Lab Director DERNA M. DEMAGGIO

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This page was last updated on: 6/4/2025