22D1062126 CLIA NUMBER - WALNUT STREET CENTER INC

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Field Name	Field Value
CLIA Number	22D1062126
LAB Type	Other - GROUP HOME FOR INTEL DIS
Facility Name	WALNUT STREET CENTER INC
Street	291 MYSTIC AVE
City	MEDFORD
State	MA
ZIP	02155
Phone	617 776-1448
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	12/6/2024
Certificate Expiration Date	12/5/2026
Facility Type	Other - GROUP HOME FOR INTEL DIS
Lab Director	EVA OSAGIEDE

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