22D2117019 CLIA NUMBER - MIDDLESEX RECOVERY PC

Laboratory Demographics

CLIA Number: 22D2117019

Facility Name: MIDDLESEX RECOVERY PC

Facility Address:
2 COURTHOUSE LANE #2
CHELMSFORD, MA
ZIP 01824
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Facility Phone Number: 978 455-0807

Facility Type: Other - NARCOTIC TREATMENT PROGRA

Certificate Type: Waiver

NPI Number: 1487971461

Taxonomy: 207QA0401X - Family Medicine
A family medicine physician who specializes in the diagnosis and treatment of addictions.

CLIA Record

Field Name	Field Value
CLIA Number	22D2117019
LAB Type	Other - NARCOTIC TREATMENT PROGRA
Facility Name	MIDDLESEX RECOVERY PC
Street	2 COURTHOUSE LANE #2
City	CHELMSFORD
State	MA
ZIP	01824
Phone	978 455-0807
CertificateType	4
CertificateEffectiveDate	8/8/2022
CertificateExpirationDate	8/7/2024
FacilityType	Waiver

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