22D2043084 CLIA NUMBER - COMMONWEALTH CARE ALLIANCE, INC

Laboratory Demographics

  • CLIA Code: 22D2043084
  • Facility Name: COMMONWEALTH CARE ALLIANCE, INC
  • Facility Address: 529 MAIN STREET
    CHARLESTOWN, MA
    ZIP 02129
  • Facility Phone: 617 426-0600
  • Facility Type: Other - NONPROFIT HEALTH PLAN
  • Facility Type: Waiver
  • Lab Director: LORI TISHLER
  • NPI Number: 1851797542
  • Taxonomy: 302F00000X - Exclusive Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 22D2043084
LAB Type Other - NONPROFIT HEALTH PLAN
Facility Name COMMONWEALTH CARE ALLIANCE, INC
Street 529 MAIN STREET
City CHARLESTOWN
State MA
ZIP 02129
Phone 617 426-0600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/27/2024
Certificate Expiration Date 6/26/2026
Facility Type Other - NONPROFIT HEALTH PLAN
Lab Director LORI TISHLER

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