22D2109401 CLIA NUMBER - MEDFORD ADHC

Laboratory Demographics

  • CLIA Code: 22D2109401
  • Facility Name: MEDFORD ADHC
  • Facility Address: 101 MYSTIC AVE
    MEDFORD, MA
    ZIP 02155
  • Facility Phone: 781 395-1900
  • Facility Type: Other - ADULT DAY HEALTH
  • Facility Type: Waiver
  • Lab Director: ALENA ZAVADSKY
  • NPI Number: 1932566056
  • Taxonomy: 261QA0600X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 22D2109401
LAB Type Other - ADULT DAY HEALTH
Facility Name MEDFORD ADHC
Street 101 MYSTIC AVE
City MEDFORD
State MA
ZIP 02155
Phone 781 395-1900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2024
Certificate Expiration Date 2/23/2026
Facility Type Other - ADULT DAY HEALTH
Lab Director ALENA ZAVADSKY

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