22D2131111 CLIA NUMBER - WAYLAND PERSONAL PHYSICIANS

Laboratory Demographics

  • CLIA Code: 22D2131111
  • Facility Name: WAYLAND PERSONAL PHYSICIANS
  • Facility Address: 109 ANDREWS AVE STE 203
    WAYLAND, MA
    ZIP 01778
  • Facility Phone: 508 358-3300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FREDERIC GOLDMAN
  • NPI Number: 1710422373
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 22D2131111
LAB Type Physician Office
Facility Name WAYLAND PERSONAL PHYSICIANS
Street 109 ANDREWS AVE STE 203
City WAYLAND
State MA
ZIP 01778
Phone 508 358-3300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2025
Certificate Expiration Date 5/22/2027
Facility Type Physician Office
Lab Director FREDERIC GOLDMAN

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