22D2123104 CLIA NUMBER - JACQUELINE STEPHEN MD

Laboratory Demographics

  • CLIA Code: 22D2123104
  • Facility Name: JACQUELINE STEPHEN MD
  • Facility Address: 1180 BEACON STREET SUITE 3D
    BROOKLINE, MA
    ZIP 02446
  • Facility Phone: 617 232-0202
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACQUELINE STEPHEN
  • NPI Number: 1083099162
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 22D2123104
LAB Type Physician Office
Facility Name JACQUELINE STEPHEN MD
Street 1180 BEACON STREET SUITE 3D
City BROOKLINE
State MA
ZIP 02446
Phone 617 232-0202
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/13/2024
Certificate Expiration Date 12/12/2026
Facility Type Physician Office
Lab Director JACQUELINE STEPHEN

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