22D2104500 CLIA NUMBER - PATRIOT URGENT CARE PROFESSIONALS PC

Laboratory Demographics

CLIA Number: 22D2104500

Facility Name: PATRIOT URGENT CARE PROFESSIONALS PC

Facility Address:
16 MAIN ST
STONEHAM, MA
ZIP 02180
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Facility Phone Number: 781 279-4000

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1588031579

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	22D2104500
LAB Type	Other - URGENT CARE
Facility Name	PATRIOT URGENT CARE PROFESSIONALS PC
Street	16 MAIN ST
City	STONEHAM
State	MA
ZIP	02180
Phone	781 279-4000
CertificateType	4
CertificateEffectiveDate	11/5/2023
CertificateExpirationDate	11/4/2025
FacilityType	Waiver

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