22D2119841 CLIA NUMBER - SHIELDS SIGNATURE IMAGING

Laboratory Demographics

  • CLIA Code: 22D2119841
  • Facility Name: SHIELDS SIGNATURE IMAGING
  • Facility Address: 680 CENTER STREET
    BROCKTON, MA
    ZIP 02302
  • Facility Phone: 866 258-4738
  • Facility Type: Other - CLINIC
  • Facility Type: Waiver
  • Lab Director: STEPHEN T. SWERIDUK
  • NPI Number: 1417320912
  • Taxonomy: 261QR0208X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 22D2119841
LAB Type Other - CLINIC
Facility Name SHIELDS SIGNATURE IMAGING
Street 680 CENTER STREET
City BROCKTON
State MA
ZIP 02302
Phone 866 258-4738
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2024
Certificate Expiration Date 10/4/2026
Facility Type Other - CLINIC
Lab Director STEPHEN T. SWERIDUK

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