22D2166028 CLIA NUMBER - SAINT VINCENT MEDICAL GROUP GERIATRICS/INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 22D2166028
  • Facility Name: SAINT VINCENT MEDICAL GROUP GERIATRICS/INTERNAL MEDICINE
  • Facility Address: 1 EATON PLACE SUITE 1BB
    WORCESTER, MA
    ZIP 01608
  • Facility Phone: 508 363-5630
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GARY BLANCHARD
  • NPI Number: 1013997329
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 22D2166028
LAB Type Physician Office
Facility Name SAINT VINCENT MEDICAL GROUP GERIATRICS/INTERNAL MEDICINE
Street 1 EATON PLACE SUITE 1BB
City WORCESTER
State MA
ZIP 01608
Phone 508 363-5630
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2025
Certificate Expiration Date 5/9/2027
Facility Type Physician Office
Lab Director GARY BLANCHARD

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