22D2151682 CLIA NUMBER - SOUTHCOAST PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 22D2151682
  • Facility Name: SOUTHCOAST PRIMARY CARE
  • Facility Address: 12 MAIN ST
    LAKEVILLE, MA
    ZIP 02347
  • Facility Phone: 508 973-0727
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WARREN WOOD
  • NPI Number: 1700393808
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 22D2151682
LAB Type Physician Office
Facility Name SOUTHCOAST PRIMARY CARE
Street 12 MAIN ST
City LAKEVILLE
State MA
ZIP 02347
Phone 508 973-0727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/25/2024
Certificate Expiration Date 7/24/2026
Facility Type Physician Office
Lab Director WARREN WOOD

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