22D1104583 CLIA NUMBER - BOSTON BREAST DIAGNOSTIC CENTER, LLC

Laboratory Demographics

  • CLIA Code: 22D1104583
  • Facility Name: BOSTON BREAST DIAGNOSTIC CENTER, LLC
  • Facility Address: 165 WORCESTER ST
    WELLESLEY HILLS, MA
    ZIP 02481
  • Facility Phone: 617 553-5300
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: ELSIE LEVIN MD
  • NPI Number: 1811222920
  • Taxonomy: 261QR0206X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 22D1104583
LAB Type Community Clinic
Facility Name BOSTON BREAST DIAGNOSTIC CENTER, LLC
Street 165 WORCESTER ST
City WELLESLEY HILLS
State MA
ZIP 02481
Phone 617 553-5300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/4/2025
Certificate Expiration Date 9/3/2027
Facility Type Community Clinic
Lab Director ELSIE LEVIN MD

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