22D2141910 CLIA NUMBER - LAWRENCE WIC PROGRAM GLCAC, INC

Laboratory Demographics

  • CLIA Code: 22D2141910
  • Facility Name: LAWRENCE WIC PROGRAM GLCAC, INC
  • Facility Address: 305 ESSEX STREET 2ND FL
    LAWRENCE, MA
    ZIP 01840
  • Facility Phone: 978 620-4740
  • Facility Type: Other - WIC PROGRAM
  • Facility Type: Waiver
  • Lab Director: KAELYN CROSS
  • NPI Number: 1104833268
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 22D2141910
LAB Type Other - WIC PROGRAM
Facility Name LAWRENCE WIC PROGRAM GLCAC, INC
Street 305 ESSEX STREET 2ND FL
City LAWRENCE
State MA
ZIP 01840
Phone 978 620-4740
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/27/2023
Certificate Expiration Date 12/26/2025
Facility Type Other - WIC PROGRAM
Lab Director KAELYN CROSS

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