22D1063493 CLIA NUMBER - GREATER BOSTON INTERNAL MEDICINE PC

Laboratory Demographics

CLIA Number: 22D1063493

Facility Name: GREATER BOSTON INTERNAL MEDICINE PC

Facility Address:
200 PROVIDENCE HIGHWAY, SUITE 203
DEDHAM, MA
ZIP 02026
Get Directions

Facility Phone Number: 781 326-1464

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1235514795

Taxonomy: 2083P0500X - Preventive Medicine
A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions.

CLIA Record

Field Name	Field Value
CLIA Number	22D1063493
LAB Type	Physician Office
Facility Name	GREATER BOSTON INTERNAL MEDICINE PC
Street	200 PROVIDENCE HIGHWAY, SUITE 203
City	DEDHAM
State	MA
ZIP	02026
Phone	781 326-1464
CertificateType	4
CertificateEffectiveDate	1/16/2023
CertificateExpirationDate	1/15/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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