22D2131812 CLIA NUMBER - EMERSON PRACTICE ASSOCIATES

Laboratory Demographics

  • CLIA Code: 22D2131812
  • Facility Name: EMERSON PRACTICE ASSOCIATES
  • Facility Address: 55 NORTH ROAD SUITE 120
    BEDFORD, MA
    ZIP 01730
  • Facility Phone: 339 215-5100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RUSSELL S. ZIDE
  • NPI Number: 1508020199
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 22D2131812
LAB Type Physician Office
Facility Name EMERSON PRACTICE ASSOCIATES
Street 55 NORTH ROAD SUITE 120
City BEDFORD
State MA
ZIP 01730
Phone 339 215-5100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2024
Certificate Expiration Date 9/4/2026
Facility Type Physician Office
Lab Director RUSSELL S. ZIDE

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