22D2061464 CLIA NUMBER - NEWTON-WELLESLEY AMBULATORY CARE CENTER

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Laboratory Demographics

CLIA Number: 22D2061464

Facility Name: NEWTON-WELLESLEY AMBULATORY CARE CENTER

Facility Address:
159 WELLS AVE
NEWTON, MA
ZIP 02459
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Facility Phone Number: 617 243-6142

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Waiver

NPI Number: 1881615052

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	22D2061464
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	NEWTON-WELLESLEY AMBULATORY CARE CENTER
Street	159 WELLS AVE
City	NEWTON
State	MA
ZIP	02459
Phone	617 243-6142
CertificateType	4
CertificateEffectiveDate	6/28/2023
CertificateExpirationDate	6/27/2025
FacilityType	Waiver

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