22D2191849 CLIA NUMBER - BEAR MT MATTAPAN, LLC

Laboratory Demographics

  • CLIA Code: 22D2191849
  • Facility Name: BEAR MT MATTAPAN, LLC
  • Facility Address: 405 RIVER ST
    MATTAPAN, MA
    ZIP 02126
  • Facility Phone: 617 296-5585
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: HOOSHANG POOR
  • NPI Number: 1982179610
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 22D2191849
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BEAR MT MATTAPAN, LLC
Street 405 RIVER ST
City MATTAPAN
State MA
ZIP 02126
Phone 617 296-5585
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director HOOSHANG POOR

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