22D2162616 CLIA NUMBER - HEADLANDS EASTERN MA LLC

Laboratory Demographics

CLIA Number: 22D2162616

Facility Name: HEADLANDS EASTERN MA LLC

Facility Address:
45 RESNIK RD STE 205
PLYMOUTH, MA
ZIP 02360
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Facility Phone Number: 508 746-5060

Facility Type: Other - CLINICAL RESEARCH

Certificate Type: Waiver

NPI Number: 1982680740

Taxonomy: 2084N0400X - Psychiatry & Neurology
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

CLIA Record

Field Name	Field Value
CLIA Number	22D2162616
LAB Type	Other - CLINICAL RESEARCH
Facility Name	HEADLANDS EASTERN MA LLC
Street	45 RESNIK RD STE 205
City	PLYMOUTH
State	MA
ZIP	02360
Phone	508 746-5060
CertificateType	4
CertificateEffectiveDate	2/26/2023
CertificateExpirationDate	2/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024