22D2151658 CLIA NUMBER - DAVENPORT MEMORIAL HOME

Laboratory Demographics

  • CLIA Code: 22D2151658
  • Facility Name: DAVENPORT MEMORIAL HOME
  • Facility Address: 70 SALEM STREET
    MALDEN, MA
    ZIP 02148
  • Facility Phone: 781 324-0150
  • Facility Type: Other - LONG TERM CARE LEVEL IV
  • Facility Type: Waiver
  • Lab Director: MS. RACHEL E. BURKE
  • NPI Number: 1891989000
  • Taxonomy: 311Z00000X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 22D2151658
LAB Type Other - LONG TERM CARE LEVEL IV
Facility Name DAVENPORT MEMORIAL HOME
Street 70 SALEM STREET
City MALDEN
State MA
ZIP 02148
Phone 781 324-0150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/24/2024
Certificate Expiration Date 7/23/2026
Facility Type Other - LONG TERM CARE LEVEL IV
Lab Director MS. RACHEL E. BURKE

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