22D1105564 CLIA NUMBER - EAST POND ENTERPRISES

Laboratory Demographics

  • CLIA Code: 22D1105564
  • Facility Name: EAST POND ENTERPRISES
  • Facility Address: 68 NORTH MAIN STREET
    CARVER, MA
    ZIP 02330
  • Facility Phone: 508 747-7813
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DAVID P. GANNON
  • NPI Number: 1659509164
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 22D1105564
LAB Type Ambulatory Surgery Center
Facility Name EAST POND ENTERPRISES
Street 68 NORTH MAIN STREET
City CARVER
State MA
ZIP 02330
Phone 508 747-7813
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Ambulatory Surgery Center
Lab Director DAVID P. GANNON

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