22D2106289 CLIA NUMBER - DANIEL RUTRICK MD PC

Laboratory Demographics

  • CLIA Code: 22D2106289
  • Facility Name: DANIEL RUTRICK MD PC
  • Facility Address: 521 MOUNT AUBURN ST STE 107-109
    WATERTOWN, MA
    ZIP 02472
  • Facility Phone: 617 775-1818
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL RUTRICK
  • NPI Number: 1568499242
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 22D2106289
LAB Type Physician Office
Facility Name DANIEL RUTRICK MD PC
Street 521 MOUNT AUBURN ST STE 107-109
City WATERTOWN
State MA
ZIP 02472
Phone 617 775-1818
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2023
Certificate Expiration Date 12/14/2025
Facility Type Physician Office
Lab Director DANIEL RUTRICK

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