22D2119616 CLIA NUMBER - VILLAGE REST HOME OF BROCKTON

Laboratory Demographics

  • CLIA Code: 22D2119616
  • Facility Name: VILLAGE REST HOME OF BROCKTON
  • Facility Address: 197 W CHESTNUT ST
    BROCKTON, MA
    ZIP 02301
  • Facility Phone: 508 583-0040
  • Facility Type: Other - REST HOME
  • Facility Type: Waiver
  • Lab Director: YVES M. LYNCEE
  • NPI Number: 1104044981
  • Taxonomy: 302F00000X - Exclusive Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 22D2119616
LAB Type Other - REST HOME
Facility Name VILLAGE REST HOME OF BROCKTON
Street 197 W CHESTNUT ST
City BROCKTON
State MA
ZIP 02301
Phone 508 583-0040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Other - REST HOME
Lab Director YVES M. LYNCEE

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