22D2120876 CLIA NUMBER - ST MARY'S INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 22D2120876
  • Facility Name: ST MARY'S INTERNAL MEDICINE
  • Facility Address: 6 ESSEX CENTER DRIVE STE 304
    PEABODY, MA
    ZIP 01960
  • Facility Phone: 978 854-6376
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUNGSIK HAHN
  • NPI Number: 1194270413
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 22D2120876
LAB Type Physician Office
Facility Name ST MARY'S INTERNAL MEDICINE
Street 6 ESSEX CENTER DRIVE STE 304
City PEABODY
State MA
ZIP 01960
Phone 978 854-6376
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Physician Office
Lab Director SUNGSIK HAHN

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